Donna Policastro, RNP April Edition of the Rhode

Island Nurse

This issue of the “Rhode Island Nurse” is filled with so much information regarding nursing issues in the state and the state of nursing; please take the time to read it from “cover to cover”. As you can see RISNA and

it’s nurse leaders have been busy over the winter months. With the election of a new president for our nation, we have received a “call to action’ to find solutions to a broken healthcare system. Nursing must continue to be an integral part of this plan. We cannot sit idly by while non nurse policy makers dictate staffing plans, delegation to unlicensed health care workers or try to influence the education of our future nurses. Nurses must agree that we are a strong profession and even though we are in a nursing shortage we must continue to move our profession forward.

RISNA continues to advocate, strengthen and advance the profession through the work that it does

current resident or

Presort StandardUS Postage

PAIDPermit #14

Princeton, MN55371

Volume 6 • No. 2 May 2009

Circulation 20,000 to every Registered Nurse, Licensed Practical Nurse and Student Nurse in Rhode IslandThe Offi cial Publication of the Rhode Island State Nurses Association

RISNA Nurses Day Event

Page 6

Save the DateRINI 2nd Annual Golf Tournament

Page 7

President’s MessageCelia Gomes McGillivray,

RN, MPH, CHES President, Rhode Island

State Nurses Association

Recently, I addressed CCRI’s Class of 2008 Associate Degree nursing program students. Over 100 students were recognized during their “pinning” ceremony. College faculty who heard my presentation suggested that I publish the speech in The Rhode Island Nurse. Here are some highlights from that speech.

It’s been seven years since I’ve earned my Associates degree in nursing from CCRI and since then I’ve significantly added skill sets and diversified my work experience. I’ve worked as a staff nurse at The Miriam Hospital and currently serve as their stroke coordinator. I’ve strengthened my expertise in quality improvement by working in ambulatory and inpatient settings where patient outcomes have improved due to the fact that we changed how patients were managed. I’ve also had the opportunity to be elected to serve on several professional associations, the Rhode Island State Nurses Association, the American Nurses Association, The Rhode Island Public Health Association, and the American Public Health Association’s governing council. I’ve been asked many times what I do to prepare myself to meet the growing challenges of the professional life in nursing. Below is a list of attributes that I strive to improve on a continual basis.

• Remain flexible and not get “set in one way” of thinking.

• Believe that I can make a difference and have I have the energy and will power to do so.

• Expect change is a life. In this way I can remain flexible and adapt more easily.

• Persevere to remain focused to achieve my goals and set new ones.

• Stay informed to support the nursing profession. Increase my knowledge and diversify my work experience by looking for opportunities to expand, learn a new skill set, or improve my competency.

• Mentor others in the field and share my experiences.

• Adhere to the code of ethics for nursing • Role model appropriate behavior and use

language that is cultural sensitive and correct. Communicate using clear and simple terms and rely on analytical thinking. Broaden my knowledge about different races and cultures especially the ones that I serve. •Trytostayconnectedspiritually. •Stayphysically and mentally fit. • Advance myself through education. •Work in different settings that include hospitals, academia, community nursing, ambulatory practices, and others. •Learn computers, a language, and clinical equipment that I use daily. •Get involved with my community by choosing to help the local schools, religious or civic organizations.

The list may sound like a lot of work. I believe that nurses need to consider how

they can advance themselves so that they can better serve the population. Nursing offers many opportunities to expand and diversify. It’s up to each one of us to examine how we can make the most of our skills and still make contributions to society.

Issues that Face NursingIn previous newsletter articles I have addressed

several issues that face the nursing profession today. They include safe staffing, nursing shortage, and the advancement of the profession. I’ve decided to reiterate some information and include some new information. Rhode Island has a special Senate Commission whose members were appointed to study the nursing shortage. The commission is co-chaired by Senator Doyle and Lynne Dunphy, Routhier Chair of URI. In a draft document, the authors reported several reasons for the nursing shortage, nursing faculty shortage, stressful and at times unsafe work environments, physically demanding tasks, and injuries. Currently we have more students who want to become nurses, but our nursing programs are experiencing space limitations. The economic environment may have caused some decline in hiring nurses, but it is anticipated the nursing shortage will continue to grow especially as patients are transitioned from the institutional setting to the home, Future health care reforms will increase the demand for nursing professionals on all levels. (Shape Study—BCBSRI, Senate Commission Undertake a Comprehensive Study of the Projected Nursing Shortage in the State of Rhode Island—draft copy)

The link between patient safety and nursing care has been established. “According to a study by Linda H. Aiken, PhD, RN, each additional patient added to the average workload of staff registered nurses increased the risk of death following common medical procedures by 7%. The risk of death was more than 30% higher in hospitals where workloads were 8 patients or more for each shift than in hospitals where nurses cared for 4 or fewer patients.” When there are more registered nurses, there are lower mortality rates, shorter lengths of stay, reduced costs and fewer complications. The latest survey of registered nurses by Health Resources and Services Administration (HRSA) noted that on average nearly 17% of registered nurses are not practicing in nursing. Staffing conditions remains one of the top reasons why nurses leave the profession. RISNA is asking all RI hospitals to adopt American Nurses Association’s nine principles of safe staffing. These principles address patient care, nurse staffing, and the organization. Recognizing that adequate nurse staffing is critical to the delivery of quality patient care, it is necessary to identify the appropriate of mix and number of nurses needed. (American Nurses Association)

Efforts to advance the profession through education have been discussed for many years. “Nursing education needs to advance to keep up with the evolving changes in health care and its increasing complexity and acuity in a diverse and aging population.” Studies indicate that nurses with a Baccalaureate in Science and Nursing or higher have increased competency and their employing facilities

President’s Column continued on page 2

Updates from theExecutive Director

Executive Director continued on page 2

Nurses DayA Tribute to Nurses

Page 2 • Rhode Island Nurse May, June, July 2009

Rhode Island NurseMission Statement

The Rhode Island State Nurses Association (RISNA), a constituent member of the American Nurses Association (ANA), is the authority on matters concerning the profession of nursing and nursing practice in the State of Rhode Island. RISNA is dedicated to the promotion, advancement and protection of nursing thereby improving the quality of and access to health care in Rhode Island.

We stand united in excellence by:❖ Providing leadership in defining standards of nursing

practice;❖ Representing the nursing profession in state and local

affairs, and;❖ Providing and coordinating information on nursing

and health care for nurses and the Rhode Island community.

Executive DirectorDonna M. Policastro, NP

PresidentCelia Gomes McGillivray, RN, MPH, CHES

1st Vice President 2nd Vice President Anita Creamer Nancy Stone, PhD, ACNP

Secretary Treasurer Linda Mendonca Linda Damon, RN

Board of Directors Linda Damon, RN Yvonne Freeman-Heredia Donna DiPrete Irene Watson, NP Lynne Dunphy Catherine Graziano Claudette Jobin, RN, MS, CCRN

Nurse Practitioner Council Co-Chairs Psych CNS Council Denise Coppa, PhD, RNP Ginette Ferszt, PCNS Jacqueline Albrike

Advanced Practice Education Consultant Lisa Marenaro, PCNS Denise Henry, RN, MS

PublisherRhode Island Nurse is published quarterly by Arthur L. Davis Publishing Agency, Inc. The advertisements and opinions which appear in Rhode Island Nurse are not necessarily endorsed by the Rhode Island State Nurses Association.

Advertising Rates: Contact Arthur L. Davis Publishing Agency, Inc., 517 Washington Street, PO Box 216, Cedar Falls, IA 50613, 800-626-4081, sales@aldpub.com. The Arthur L. Davis Publishing Agency, Inc. reserves 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.

Rhode Island State Nurses AssociationBaker-Hanley House

67 Park PlacePawtucket, RI. 02860

have lowered mortality and adverse events. Patients experience improved outcomes and have shorter hospital stays. Because nurses are involved in every aspect of health care delivery, nurses needs to be more educated. The quantity of information related to health and nursing care is expected to increase significantly over the next 10 years. Currently in some health care facilities, career mobility and advancement is dependent on a baccalaureate degree in nursing, or higher.” (Senate Commission Undertake a Comprehensive Study of the Projected Nursing Shortage in the State of Rhode Island - draft copy)

Recently RISNA conducted a survey for Rhode Island nurses. We received over 100 completed surveys with the majority of respondents holding an associate’s degree. The results are as follows: 68% agreed that registered nurses need to earn their Bachelor’s of Science in Nursing; 86% believed that earning a Bachelor’s Degree of Science in Nursing supports the growth of the profession as a scientific discipline; and 91% agreed that registered nurses who earn their Bachelor’s of Science in Nursing feel more empowered and increase their mobility. From this sample a majority of the registered nurses agreed that earning a Bachelor’s Degree of Science in Nursing was needed and over 90% reported that

the degree would help them with advancement and professional growth. RISNA plans to conduct more surveys to examine the issues and barriers.

Code of Ethics Provisions—taken from the American Nurses Association

1. Nurses practice with compassion and respect for inherent dignity, worth, and uniqueness for every individual unrestricted by social economic status, personal attributes, nature, health problems.

2. Nurse’s primary commitment is to the patient. (individual, family, group, community).

3. Nurses promote, advocate, and strive to protect health, safety, and rights of the patients.

4. Nurses are responsible and accountable for individual nursing practice, and determine appropriate delegation consistent with nurses’ obligation to provide optimum patient care.

5. Nurses owe the same duties to self and others, including responsibility to preserve integrity, safety, maintain competence, and continued personal professional growth.

6. Nurses participate in establishing, maintaining, improving health care environments, and conditions of employment conducive to provision of quality health, consistent to values of profession through individual and collective action.

7. Nurses participate in advancing the profession through contributions to practice, education, administration, and knowledge development.

8. Nurses collaborate with other health professionals and public, promoting community, national, and international efforts to meet health needs.

President’s Column continued from page 1

on the state and federal level. By the time you read this column, the report from the Senate Commission on the Nursing Shortage will be available. The nursing shortage, believe it or not, has provided our profession with an opportunity to educate and legislate for positive changes for the profession and for the future of nursing in Rhode Island.

When the economy is in turmoil and we have less income due to lay offs and downsizing, it is sometimes necessary to disregard renewing our memberships to our professional association. If this is the case, please consider the fact that RISNA still needs you. YOU are RISNA. In these trying times please remember that without resources their can be no expectations. We as a profession and as professionals must remain positive and united. Let’s continue the journey together! ! !

Donna

Executive Director continued from page 1

May, June, July 2009 Rhode Island Nurse • Page 3

NP Council NewsNews from the RI Nurse Practitioner Council

EXECUTIVE COUNCIL:Co-CHAIR Denise CoppaCo-CHAIR Jackie AlbrikesSECRETARY Annette Fonteneau

Recently, I was speaking with a colleague who met with another nurse practitioner for peer supervision. During this meeting, the second nurse practitioner mentioned that she was not involved in the NP council. When asked why, she simply stated that “it has nothing to do with me”. “Nothing to do with me?”, I thought. It just not true. It has EVERYTHING to do with you, and every other NP practicing in the state. There have been some changes recently that many NPs are still unaware of. For instance, did you know that in RI you can sign for workers compensation cases? (RI and other states are actively working with our legislators to try to get this mandated on a federal level as well!) Are you aware the language has changed for prescriptive writing privileges? These are some of the many issues that have been addressed by the NP council.

I am challenging all NPs to attend at least one meeting of the NP Council. The meetings are the

We are thrilled to congratulate our 2009 Rhode Island AANP Excellence Award recipients. This year’s NP Excellence Award recipient is Anne Neuville, MS, RNP who is the NP Council’s Government Affairs Liaison. The NP Advocate recipient is Sylvia Weber, MS, RNC who is the RISNA Government Affairs representative. It was very significant this year that the AANP chose recipients who have been, and currently are, so instrumental in all our hard work on the legislative front. The AANP has been actively supporting all our recent legislative actions and many of the other states are watching us forge our way legislatively and learning from our triumphs. It is truly an honor for the Council to support these two award recipients in this active legislative domain.

Please watch for both award recipients’ press releases in the next issue of the Rhode Island Nurse as well as in your local newspapers. Congratulations Anne and Sylvia!

We want to recognize you! If you have any noteworthy news or updates (i.e. publications, promotions, new job appointments, etc) please email Allison at thejedsons@aol.com so we can spread the news and give you due accolades!

REMINDERSANA/RISNA members receive discounts

on malpractice insurance. Go to http://www.seaburychicago.com/cwp.asp?assn=ANA-CMA for more information.

Don’t forget the many benefits of joining the American Academy of Nurse Practitioners (AANP) such as: daily SmartBrief, an electronic newsletter delivered daily, Monday–Friday, to your email address. AANP SmartBrief compiles essential healthcare news and information from media sources around the country and delivers them to you in a clear and concise format, with links to the news sources. Also obtain free access to customized Smart Ideas, an AANP-branded quarterly patient-focused magazine for distribution in reception areas of practice settings, free or reduced rates at Pri-Med meetings around the country and free registration of practice information on NP Finder, the web-based NP locator service that helps consumers search for NPs by specialty, city, state, and zip code.

If you are due for NP recertification and were certified by ANCC before 1994, the AANP will grant you reciprocity; the cost is $95.00 for AANP members. Also remember that the Rl NP Council is a member of the AANP and as such generates many member benefits including reduced membership fees.

MEMBERSHIP Thank you to all who have been making a sincere

effort to attend the monthly meetings on Mondays. Meetings are still on the first Monday of the month at 6pm, Kent Hospital, Trowbridge Building, Room 5B. Watch your emails for the reminders and please consider taking some time out of your busy lives to help advance Rl nurse practitioners and network with your colleagues.

Reminder: If you are not on the NP list-serv, general information about the mailing list is at: http://risnarn.org/mailman/listinfo/risnalistserv01_risnarn.orq or take a moment to send your request and preferred email address to risna@prodigy.net Please take a moment to sign up!

Hello Members: March finds all of us digging out once again! Bad

weather aside, the NP Council has moved ahead this winter with our legislative agenda. The government affairs committee has worked together with the council to author the primary care provider bill, that would designate nurse practitioners as primary care providers for all of the health insurers in the state. This will increase access to nurse practitioners for all patients. It does not take away from the fact that nurse practitioners continue to work collaboratively with physicians and other health care providers as stated in the RI Nurse Practice Act. It clarifies the relationships of the insurance companies with nurse practitioners. Massachusetts passed similar legislation last year with great legislative support. With the leadership RISNA’s legislative liaison. Sylvia Weber, and our NP council government affairs liaison, Anne Neuville, we are very optimistic that we will be successful. The council will stand with RISNA to support a number of bills submitted from other health care organizations in the state.

The Primary Care Physician’s Advisory Committee (PCPAC) has nurse practitioner council representation that puts us “at the table” for many discussions and advisory decisions to the director of health regarding issues that cover all aspects of health care in the state. During the past year, discussions have included everything from retail based clinics (the committee did not support) to the Lifespan1 Care New England merger (the committee had specific reservations around primary care delivery models). Most recently, a very informative session took place between PCPAC and Gary Alexander and Ann Martino, economic officers from RI HHS. This discussion was on the global Medicaid waiver, negotiated by Governor Carcieri with the US CMS office. If this is accepted as written, it could have significant impact on the health care of impoverished children and elders in need of long term care. I suggest that interested parties contact one of these 2 individuals if you have specific questions.

Lastly, the University of Rhode Island is moving ahead with its DNP program. The hold up has been approval from the Board of Governors for Higher Education. There is fear that this program will cost more money for the university and not have the output of graduates to justify the infusion of funds. The good news is that URI will NOT be closing the Gerontological Nurse Practitioner program. We have some plans in place that will allow us to partner with community agencies to provide clinical placements for the students.

The council has voted to change its policy on elections. Elections will be held at the annual meeting in September, rather than in January so that all interested people can take part in the vote. A vice chair will be elected to work with the chair for one year before becoming chair. We hope to start that process in September, 2009.

We look forward to your involvement in the council! Our business meetings are on the first Monday of the month. Be sure that RISNA has your email address so that you can be notified about all council happenings.

Til Next Installment... Peace.Denise Coppa, PhD, FAANP

RI Nurse Practioner Council

March 3, 2009

NP SPOTLIGHT

VIEW FROM THE CHAIRfirst Monday of the month at the Trowbridge building at Kent at 6 pm. Become more active in YOUR NP council. Let YOUR voice be heard. Instead of thinking “it is the same old thing all the time” without actually having attended a meeting, come to see what it is really all about. We have made so many advances legislatively in the past few years alone; and all were issues brought forth by your NP colleagues. This is the time and the place to address some of your concerns and to help ensure that issues that are of concern to you and your fellow NPs are being addressed.

Contact RISNA to be included on the email list-sew. You will get reminder notices about meetings, information about upcoming legislative events, and other events, meetings and CEU offerings that might be of interest to you.

I am looking forward to seeing some new faces (and perhaps some old faces that have not been at any meetings recently) at the next meetings! Thank you for accepting the challenge.

Sincerely,Jackie Albrikes

Page 4 • Rhode Island Nurse May, June, July 2009

Sylvia Weber

This has been a busy session as budget concerns loom. We continue to work on health care reform, the nursing shortage, safe staffing, advancing nursing education, and environmental issues including work place safety. We have initiated meetings with stakeholders to discuss safe staffing and the advancement of nursing education. As with everyone, we are concerned about the financial crisis and its impact on those we care for and care about. We continue to work with other organizations on issues that are a priority for RISNA and are a part of several coalitions. Since its passage, we have been active with others in addressing our concerns related to the Global Medicaid Waiver, its impact and how to accomplish its goals without the risks. Donna Policastro continues to represent RISNA on the Senate Commission to Study the Projected Nursing Shortage in RI. Peter Fontaine and I also attend the meetings as guests. The report and its recommendations are being finalized and a bill is being introduced to extend the commission for another year since there are several issues that the Commission wants to continue to address. We’re following several bills and will be testifying when they come to hearing. Being at the State House and attending committee hearings is an experience that everyone should have, even if it’s only once, and I would enjoy showing you around. Please feel free to contact me with any questions, concerns, and/or ideas you may have that relate to government relations. You may also consider joining our active and fun committee.

Government Relations

A Lucky Nurse at the InaugurationCynthia Cardon Hughes, MSN, RN

Staff Development Specialist, The Miriam Hospital, Providence, RI

INHL Associate, The Institute for Nursing Healthcare Leadership, Boston, MA

It was dark and cold, but at 5 a.m. there was already more traffic than usual for that hour. I entered the Metro with my companions: My host’s son, who had arrived in Washington from his college in Connecticut, and his two friends, who had driven from Georgia. We were converging with almost two million others to witness the Inauguration of Barack Obama as the 44th President of the United States.

Twenty minutes later, I emerged from the subway into a surreal scene: Buildings lit by high-powered floodlights; streetlights still casting their sodium-vapor glow; police directing traffic at every corner; and most striking of all; crowds of people streaming in both directions on the sidewalks, moving peacefully, bundled against the 20-degree air and even colder wind chill, smiling, joking, talking, and warmly acknowledging their common goal to be present for the historic occasion.

It was 5:30 a.m. The illuminated Capitol dome blazed in the pre-dawn hour with a waning crescent moon nearby. I reached one of the entry points for the parade route, having worked my way past a four-block line of purple ticket holders. They would be among the lucky ones who got to the Capitol grounds. Not all of the ticket holders managed to pass through before the Inauguration started.

But I was especially lucky. By 7 a.m., the pale blue sky revealed only a few clouds, and I no longer had to fight the cold; I didn’t have to wait in that long line. I was carrying a badge that gave me access to a building on Constitution Avenue, on the parade route. I was soon indoors, on the 7th floor, overlooking the Capitol; enjoying a scrumptious breakfast and lunch buffet; watching the Inauguration activities through the windows and on the large screens displayed in the rented office suite; and toasting the new President with a glass of bubbly.

I owed my good fortune to the American Nurses Association Political Action Committee, which had bestowed on me that entry badge. The venue was hosted by the American Association of Nurse Anesthetists, with support from multiple sponsors. It was my honor to meet the ANA nurses in attendance, who included Rebecca Patton, RN, MSN, CNOR (Ohio), ANA President; Lori Lioci, MSN, FNP-C, NP-C (Alabama), ANA-PAC Board of Trustees Vice Chair; and Rose Gonzalez, MPS, RN.

It was a brilliant day. In the distance: The West Front of the Capitol where the oath of office was administered; the twinkling of the jewels on Aretha Franklin’s hat; the crowd on the Mall; the security personnel on the roofs. In the foreground: the military Honor Guard—Navy, Army, Air Force, Marines, Coast Guard—lining Constitution Avenue and saluting the motorcades as they arrived at the Capitol from the White House and as they carried the new President back towards Pennsylvania Avenue; the surging spectators, arriving for hours on end; the circling helicopters. Inside: A sense of marvel, matching the mood on the Mall. On the roof-top terrace of our building: A bird’s eye view of the parade. Thank goodness for ski pants and hand warmers.

ANA-PAC not only gave me entry to this wonderful location from which to watch the Inauguration, but

Illinois State Society Inaugural BallTop Row: Michelle Artz, Mary Behrens,

Linda Gural, Patrick Voight, Sarah Jarrett, Pat Messmer.

Bottom Row: Barbara Curtis, Cynthia Hughes, Anne McNamara.

In the coming months I will challenge all of you to participate in the process, either directly or by at least supporting RISNA and it’s political action fund. I look forward to working with you in creating positive changes for nursing in Rhode Island and access to quality healthcare for our patients. I welcome your voices and ideas, knowing our vast wealth of varied experience can be a powerful and much needed resource moving forward, especially now.

Anne E. Neuville, RN, MSN, FNP Chair RISNA Government Affairs Committee

it also waved its wand and produced a ticket to the Illinois State Society Inaugural Gala, held the evening before at a large downtown hotel: Reception and dinner for 1500 people followed by dancing for perhaps 3000 more; several ballrooms, many bands and orchestras; and of course, a couple of thousand spectacular gowns. If a pumpkin and mice had conveyed me to Washington, it would not have been more magical.

And who did I meet at the ball? A dynamic group of activist nurses. Barbara Thoman Curtis, RN, founder of the first nursing political action committee in the nation and then of what would become ANA-PAC. Sara Jarrett, RN, MS, MA, EdD (Colorado), Chair of the ANA-PAC Board of Trustees. Mary Behrens, RN, MSN, FNP-C (Wyoming), ANA-PAC Treasurer, Pat Messmer, PhD, RN-BC, FAAN (Florida), ANA-PAC Board of Trustees Secretary. Linda Gural, RN, CCRN (New Jersey), ANA Board of Trustees. Anne McNamara, RN, PhD, ANA Board Past-Treasurer. Patrick Voight, RN, BSN, MSA, CNOR, AORN President-Elect. Michelle Artz, MA, ANA Associate Director of Government Affairs. Their CVs are impressive. So were their moves on the dance floor.

Yes, I was lucky. But all of us who are nurses are lucky. We are lucky to be members of a profession that enjoys high public trust and that makes a critical contribution to the health of the nation. I’ve been a long-time supporter of ANA-PAC because I strongly believe that nursing’s voice must be heard in Washington to advocate for affordable, accessible, coordinated healthcare and for the availability of professional nurses to help deliver that care. The nursing leaders I met in Washington are among the thousands of nurses working at organizational, community, state, and national levels to improve care.

President Obama has challenged each of us to help bring about change we can believe in. For ANA, on behalf of the profession and the public, this means advocating for Nursing Voice (bringing all our knowledge and experience to the table); Nursing Workforce Development and Deployment (attracting and retaining practitioners and faculty); Full Utilization of Nursing Skill and Education (removing barriers to practice); and Nurse Staffing (promoting patient safety). These are changes I believe in. ANA-PAC and President Obama have inspired me to do more to bring about these changes. I hope they inspire you, too.

May, June, July 2009 Rhode Island Nurse • Page 5

Green Column Sylvia Weber

RISNA continues to work on our environmental agenda and continues to work with other organizations and coalitions. As a member of the Environmental Council of RI, Health Care Without Harm and Toxic Information Project, we are able to share ideas and partner on important issues. We recently testified on a bill at the House HEW Committee to ban toxins from containers that children use. We are watching several environmental bills on both the House and Senate side and will either testify or admit our position to the respective committees. If you have an interest in coming to the State House to hearing or to testify, please contact me. It’s an experience no one should miss.

Our Environmental Affairs Committee continues to grow and meets about monthly to establish and accomplish our priorities for 2009.

PLEASE SAVE THE DATE for our all day conference on Saturday November 14, 2009. We’ll be having nationally and locally recognized speakers. All who attend will receive our booklet and CD entitled, “RISNA’ s Principles of Occupational and Environmental Health with Resource Guide.”

In January, Chris Gadbois, member of our committee and President of the Developmental Disabilities Nurses Association, and I went to a conference in Baltimore, MD. Put on by the Learning and Developmental Disabilities Initiative. It was very informative and we had the opportunity to meet with our federal delegation on environmental issues, health care concerns and nursing issues.

There are many wonderful web-sites about environmental issues and, if you’re interested, I would be happy to forward them to you. For more local information you can check out the ECRI site at www.environmentcouncliri.org. We are looking for volunteers to assist us with our ambitious goals and students who would like to join us for class credit are more than welcome.

We’re looking forward to a wonderful and productive year. Please feel free to call me and please consider joining us in protecting the environment we are borrowing from our children and grandchildren.

Mississippi’s 2009 Nightingale Awards Gala

Held on March 2, 2009Jackson, Mississippi

Ricki Garrett, Ph.D.Executive Director, Mississippi Nurses

Associationand

Guest JudgeDonna Policastro, RNP

Executive Director, RISNA

After the New Year, I found myself reflecting on how I became active with RISNA. I had spent two decades of my career being a member in name only e.g. reading the newsletter and attending a few conferences. I am now immersed in RISNA’s activities.

It started with a phone call from one of my graduate school mentors, Dr. Janet Hirsch. Janet was my professor in Nursing Leadership. She was inspirational and brought out the best in me. I was surprised by the call. I had been out of school for many years. The phone call came in the evening at my home. I immediately went into the “professional student” role while standing in my kitchen wearing my flannels.

Janet asked if I would like to serve on the Cabinet of Nursing Practice. “Absolutely.” “Sure.” Janet is terrific and I did not want to disappoint her but I did not know what the Cabinet of Nursing Practice was. I told her that I would participate and asked for the date, time, and the location of the meeting. Janet kindly explained that she was a member of the Nominating Committee and I had to be elected before I could serve. Oooops! My ignorance showed big time. I got over it, filled out the paperwork when it arrived, and submitted it as directed.

I got elected! My excitement in winning was tempered by the realization that my name was one of three nominees. The instructions on the ballot indicated “select three”. I felt better when Sylvia Weber, the newly elected president, informed me that she was a “select one” but that it is not automatic to win. There must be a certain percentage of voters who check off your name. Feeling a bit better by that yet also anxious that winning meant actually attending meetings, I appropriately this time found out the date, time and location.

Marie Ghazal was the Chair of the Cabinet on Nursing Practice when I was elected to serve. I had initially planned to stay quiet in the meetings, not making any faux-pas. I had a preconceived false impression of RISNA. I thought it was a group of nursing professionals who were out of touch with the needs of “client-side” nurses. I feared I would stick out like a sore thumb. Well I was wrong about RISNA. Marie was current with nursing issues and epitomized the nursing profession. She was articulate, welcoming and caring of the Committee members, and down to earth. She provided a comprehensive orientation and I no longer felt clueless. I felt that I could contribute. Marie became my mentor. She empowered me to act beyond my comfort zone while supporting me in the process. In the February 2009 edition of the American Nurse Today, Sherman and Murphy speak about this phenomenon and how the mentor can help her protege open new career doors and “gain a new perspective on her work” (p.4). This was my experience with Marie.

A Heartfelt Thank You to Marie Ghazal

For the first time ever, I spoke at a Public Hearing where the voices of RNs needed to be heard. The hot issue at the time was RNs and dispensing stock medication. Marie was also there and spoke on behalf of nursing.

I learned a lot from watching Marie. She networked at events representing RISNA while promoting nursing throughout her conversations. She always made sure to introduce me and share her contacts.

Marie eventually became a member of the Board of Directors of RISNA and encouraged me to run for the Board. I would not have considered running without Marie’s encouragement.

As many of you know, I was elected to the Board and later elected as RISNA’s president. Marie has remained a major support to me, celebrating my successes and being readily available when I seek direction.

I was fortunate to meet Marie and engage in a mentoring relationship. She was my introduction into RISNA, a career changing experience for me.

The moral of this story is -take an opportunity whenever it may present itself, try on new roles and see how they fit, and seek mentors to help you along the way. You will be surprised how many people will lend you a hand. Marie’s was the first to reach out to me. There are many helping hands at RISNA where I am sure that you will find a mentor.

Marie Ghazal (center) has mentored both Mary Dwyer (left), immediate Past-President RISNA, and Celia

Gomes-McGillivray (right), current RISNA President.

Page 6 • Rhode Island Nurse May, June, July 2009

Rhode Island State Nurses Association Nurses Day A Tribute to Nurses

RISNA Celebrates Nursing ReceptionThursday, May 7, 2009 • 6:00 p.m. - 8:00 p.m.

Marriott Providence, One Orms Street, Providence, RI 02904

Registration Deadline... April 30, 2009

DIRECTIONS TOMarriott Providence

Providence (PVDPVD (12 mi N)

Take I-95 North to Exit 23 (State Capitol Exit). Stay to the Right at the fork in the road and then make a left at the traffic light onto Orms Street. The

Providence Marriott will be on the left.

When we buy a new car, we head to the dealer armed with pages of information on options and pricing. We compare notes with friends and scour the Web before investing in a new camera.

But when we enter the hospital as patients, it’s a different story. Many of us shed our vigilant “buyer beware” persona and become passive recipients of care. That’s fine, as long as we’re OK with the possible consequences. The fact is, hospitals are dangerous places—not because caregivers aren’t doing the best job they can (they are)—but because the nature of hospitalization has changed.

I learned this the hard way. In August of 2005, late at night after getting up to use the bathroom, my Dad tripped and fell down the stairs. The surgery to repair his fractured vertebrae went well, but the C-diff infection that caused his colon to rupture led to his death 6 months later.

“C-diff”, “MRSA”, “VRE” - like most patients and their families I had barely heard of these infections. Now, these awkward-sounding names roll off my tongue—too familiar, unfortunately. We patients and families wrongly assume we can’t be at risk in the “healthiest” place of all—the hospital. Yet the proof is in the statistics. I have since learned that 99,000 people a year—271 each day—die of a healthcare-acquired infection. The problem is getting worse. And most of these infections are preventable. So why do they happen?

As a recent article in Parade Magazine pointed out “The problem is not that we have an epidemic of negligent doctors and nurses. Rather, it’s that the health-care system has grown so complicated that there is a greater chance than ever of things falling through the cracks.”

So what are we “consumers” of health care to do, other than wring our hands and hope for the best?

We need to “patch” those cracks. Not with new software, testing and technologies (although they do have a role)—but with the collective eyes and ears of those doing battle on the front lines. That begins with the nursing staff.

ATTENTION PATIENTS:WE NEED NURSES, AND NURSES NEED OUR HELP

Unfortunately, reduced staffing is a big part of the problem, according to research. Take something as simple as bedsores: One study showed that the lower the nurse-to-patient ratio in hospitals, the higher the rate of bedsores. It’s easy to understand. Moving patients in bed usually prevents this problem, but nurses are needed to do that. And once bedsores take hold, they can lead to serious infections.

Why would hospital administrators allow staffing levels to erode? Perhaps because, in the face of a cost squeeze, and absent patients’ (clients’) demanding better, there is little pressure to do otherwise. Other priorities—publishing research, installing a new MRI suite, opening a new wing with high-end patient environments—all might bring more to the bottom line.

The nurses I’ve talked to remain committed to priority one: the patient outcome. They are multi-tasking as fast as they can, trying to deliver top-notch care in the face of dwindling resources. They are our best advocates... but more and more they need our help.

That brings us to the second stakeholder on the “front lines” of battle—us patients. If we want to ensure we emerge from the hospital with the best possible outcome, we need to add our voices. We can:

1) Get educated. Read about HAI’s, how you contract them and how medical mistakes occur. That way you can avoid behaviors that put you at risk, and hold caregivers to a standard or care.

2) Give feedback to hospital administrators about staffing levels, adherence to standards, and how it impacted your (or your loved one’s) care. If you had a bad experience, tell them, in writing. Hospitals want your business. Tell them how they can earn it. (Good feedback is welcome, too.) Not satisfied? Alert the media. Write a letter to the editor of your local newspaper.

3) Be a partner with your caregivers. If you’re going to be bedridden in the hospital, consider bringing hand sanitizer for the bedside (hospitals often provide rooms with hand sanitizer, but it’s usually bolted to the wall). Gently remind visitors and caregivers to clean their hands before touching you. Tap your caregivers’ goodwill and expertise by learning all you can about your illness, treatment and tests. Again, educating yourself about infection equips you to ask the right questions and use the right behaviors.

4) Lobby for change locally and nationally. Is your state among the 50 percent that have a hospital infection reporting law? Would you like your hospital to warn you of the risk of infection and the steps you can take to stay safe? Are you satisfied with the state-mandated training level of the nursing staff taking care of you? Speak up to your lawmakers. And remember it’s not just your health, but your wallet at risk: the cost per hospital infection per patient is an additional $15,000. Taxpayers are among those who foot the bill for uncompensated care.

The best advice: get active, not angry. No one would suggest we patients or advocates manage our own care, or become overbearing or unreasonable (a losing strategy for sure). We need our caregivers and respect them for their lead role in managing our health and recovery. But at a vulnerable time in our health, when so much is out of our control, isn’t it empowering to know we can have some control after all? Wouldn’t you rather avoid looking back in regret and saying “If only I’d known...”

Trust me, it’s a sad thing to wonder.Pat Mastors, founder of The Empowered Patient

Infection Defense Kits (www.lnfectiondefense.com), championed Rhode Island’s hospital infection reporting bill and serves on the legislative steering committee guiding its implementation. She is a former medical reporter and news anchor.

May, June, July 2009 Rhode Island Nurse • Page 7

Rebecca Parant, MSN, RN,

Consulting ServicesBiography

Becky Parant has been a registered nurse since 1987 with experience in a wide variety of practice settings. She is currently employed with Bradley Hospital on the inpatient unit of the Center for Autism and Developmental Disabilities.

In addition to her nursing experience, Becky has worked in management, sales and provider relations. She earned a Master’s of Science in Health Services Administration in 1992 from Salve Regina University. In 2008, she earned another Master’s degree, this one in Nursing & Education, from the University of Phoenix online program.

Nursys® Article (Compact jurisdictions)

Employers/PublicIf you or your organization needs to increase your

efficiency in verifying nurse license and/or checking a nurse’s discipline status for employment decisions, then look no further than NCSBN’s secure, online verification system, Nursys® (www.nursys.com). The nursys.com Web site contains data obtained directly from the licensure systems of the boards of nursing through frequent, secured updates.

Employers and the general public can now verify licenses and receive a detailed report within minutes, free of charge. This report will contain the name, jurisdiction, license type, license number, compact status (multistate/singlestate), license status, expiration date, discipline against license and discipline against privilege to practice (PTP) of the nurse being verified. Currently nursys.com is the only verification tool available that provides status of a multistate licensee’s privilege to practice in remote Nurse Licensure Compact (NLC) jurisdictions.

NursesWhen a nurse applies for endorsement into a

state, verification of existing or previously held licenses may be required. A nurse can use Nursys.com to request verification of licensure from a Nursys licensure participating board. A list of licensure participating nursing boards can be found at Nursys.com.

In order to be eligible for a multistate license in the NLC, the nurse must legally reside in an NLC state. An active, unencumbered, multistate license allows the nurse to practice in all NLC jurisdictions. Questions about NLC eligibility and legal residency can be directed to the board of nursing in the nurse’s state of residency.

Verifications can be processed by completing the online Nursys verification process. The fee for this service is $30.00 per license type for each state board of nursing where the nurse is applying. Nursys license verification is sent to the endorsing board immediately. Please visit www.nursys.com for more details.

For more information, email nursys@ncsbn.org, call 312.525.3780 or visit Nursys.com.

Additional information on the NLC is available by visiting: https://www.ncsbn.org/nlc.htm

RINI: Caring for Nursesby Mary F. Dwyer, MS, MEd, PCNS

RINI President

You may have heard the letters “RINI” and wondered what RINI is all about. The following is an attempt to answer the most frequently asked questions: Here we go...

Frequently Asked QuestionsWhat do the initials RINI stand for?

The Rhode Island Nurses Institute

What’s the difference between RINI and RISNA?RISNA is classified as a 501(C)6 and as a

membership organization is not considered tax-deductible. They are separate organizations. RINI is a 501(C)3 charitable tax-deductible organization.

Does the tax-exempt status matter?It matters for fundraising. Often contributors

appreciate giving to a charitable organization for tax-deduction purposes. Also, many grants are available to 501(C)3 organizations only. This limits RISNA’s ability to apply for grants.

How are RINI and RISNA connected?RINI raises funds and develops and manages

grants that help to support its own mission as well as the mission of RISNA.

What is RINI’s mission?Simplified, RINI cares for nurses. It does so by

advancing knowledge of the nursing profession; assisting nurses in need; encouraging nursing research and career development; and developing financial resources for relevant research.

What is the difference between RINI and the Nursing Foundation of Rhode Island?

They are both foundations but with different missions. The Nursing Foundation of Rhode Island provides scholarship dollars to nursing. RINI does not duplicate this effort. The RINI role is assisting nurses in other ways, e.g., providing day care dollars for a nurse/student to return to and/or complete nursing school.

What have you accomplished so far?RINI is in its embryonic stage. Nonetheless we are

off to a good start. In this past year, RINI utilized a grant award to collaborate with RISNA to create two educational sessions accepted by the RI Department of Health Board of Nursing for impaired nurses to complete as part of their diversion contract. These two Saturday sessions were well attended by a combination of nurses representing the desire for professional development and those fulfilling the requirements of their individualized diversion contract.

RINI has raised funds through a generalized mailing, a fund-raising event at Barnes & Noble in Warwick and a very successful “First Annual Golf Tournament” held September 18, 2008 at the Cranston Country Club. Anita Creamer, Chair of RISNA’s fundraising committee led the way in creating this event with Annette Fonteneau, treasurer of RINI, providing assistance throughout.

What are you working on now?RINI is in the process of developing an on-

line resource center for nurses in the area of peer support, not only in the area of impairment, but in other peer assistance areas as well. This website is currently under development and will be linked to the RISNA website. In addition, the two educational sessions mentioned above will be placed on-line.

With the assistance of RISNA Board members, RINI is preparing for its second Annual Golf Tournament to be held on Monday, August 10th at the Richmond Country Club. Anita Creamer, RN an avid golfer is chairing the committee again this year, and we are looking forward to another successful event.

On Friday, September 25th a conference will be held addressing nursing and addiction. RINI is co-sponsoring this event with the Nursing Foundation of Rhode Island. We have contracted with RISNA to be the program developer. It will take place at the Hilton in Providence. Stay tuned and save the date.

Are you still reading this?Not an FAQ but if you are, thanks for your interest.

You can learn more about RINI by calling 305-3330. Please watch for updates in the next edition of the RI Nurse.

Page 8 • Rhode Island Nurse May, June, July 2009

by Marie Ghazal, RN, MS, Vice President of Patient Care & Nursing, Providence Community

Health Centers

Oral health is a vital yet overlooked part of health and well-being with children and adults. Among children 5 to 17 years of age dental caries (tooth decay) is the most common childhood disease and one that is clearly preventable. Along with poor eating habits, chronic dental problems in school-age children can lead to a host of other problems. Children who lack appropriate dental care are likely to develop a poor self image, have difficulty concentrating, experience increases in school absenteeism, and encounter reduced academic performance in school (RI Kids Count, The Dental Safety Net in Rhode Island, Special Report, June, 2006).

In Rhode Island approximately 21% of all children live in families below the federal poverty threshold and insurance is a strong predictor of access to dental care, according to RI Kids Count data. The Providence Community Health Centers, Inc (PCHC) is a safety net provider for health care delivery in Rhode Island, one of many organizations in Rhode Island providing comprehensive oral health care to children regardless of their insurance status or ability to pay. Safety net providers provide medical and dental care to patients who have no insurance, commercial insurance or public insurance. These safety net providers serve thousands of underserved children and adults, and a high volume of patients enrolled in Rhode Island’s Medical Assistance Programs. There is a safety net provider in each of the six core cities in Rhode Island (Providence, Central Falls, Newport, Pawtucket, West Warwick and Woonsocket). This network of providers has grown and remained strong for the past eight years.

PCHCs Dental Clinic opened in May 2005 for children and pregnant women. The clinic is located at 557 Broad Street in South Providence, easily accessible by bus or car. Quality oral health care is provided by a team of dentists, dental hygienists and dental assistants Services provided include exams, x-rays, fillings, cleanings, sealants, fluoride treatments, simple extractions and limited emergency treatments. The focus of treatment is on preventive and restorative care. Evening appointments are provided and children without

Dental Safety Net Service Providers–Support for Uninsured and Low-income Children

Dental Hygienist, Carleen Signore.

Volunteers & Staff, PCHC Dental clinic.

insurance are currently enrolled under a special state appropriation.

The dental service delivery providers attempt to bridge the gaps for the low-income and uninsured children in Rhode Island. They are unable to meet all of their patients’ oral health needs, however, without them many children in the state would be without a dental home and a good start to a healthy life.

For further information about PCHCs dental services contact Marie Ghazal @ mghazal@providencechc.org or visit the website at www.providencechc.org

May, June, July 2009 Rhode Island Nurse • Page 9

by Janine Cotugno

Marcella Remer Thompson MS, CSP, MSN, RN, COHN-S, a member of the Rhode Island Association of Occupational Health Nurses (RIAOHN), an Organizational Affiliate of RISNA, has been named a Fellow by the American Association of Occupational Health Nurses (AAOHN). AAOHN Fellows are leaders who demonstrate outstanding accomplishments in the field of occupational and environmental health nursing in the areas of clinical practice, education, research, management and policy.

Marcy holds two Masters’ Degrees, one in nursing from Boston University and one in occupational health from the Harvard School of Public Health. She is currently a doctoral candidate at the College of Nursing, University of Rhode Island. She is board certified as an occupational health nurse specialist (COHN-S) and as a certified safety professional (CSP). Marcy has provided vision and leadership to the profession through her work experiences which include founding clinical director of one of the first hospital-based occupational health services in the U.S., consultant to small- and medium-sized businesses for occupational/environmental health and safety, principal safety engineer for a semiconductor manufacturing facility and clinical adjunct faculty at two local universities. After the Station Nightclub fire in 2002, she developed an educational program in fire safety for occupational health nurses to demonstrate how one additional exit and minor structural changes to the existing exits would have allowed all attendees to safely exit the club. In 2004, she was appointed by RI Governor Carcieri to Chair the Rhode Island Commission for Mercury Reduction and Education. After a mercury contamination incident resulted in the evacuation of an entire Pawtucket RI apartment complex in 2005, Marcy developed emergency response protocols for the RI Department of Health Office of Environmental Risk

Occupational Health Nurses are Award Recipients

PCNS Council Executive

CommitteeRl NewsNew Program to Support New Moms: (Sally Harrison PCNS is the Clinical Program Director)

Families First Rl, a non-profit organization matches volunteer mentor moms to moms of newborns, who may be at risk for, or are already experiencing Postpartum Depression and to women in the late stages of pregnancy. At the core of our program are our dedicated and compassionate mentor moms who volunteer their time and provide non-judgmental support to their matched mentee mom. The relationship that develops between these women is extraordinary and epitomizes the term, “mothering the mother” or as Families First calls it, “Moms Helping Moms.”

To learn more about becoming either a mentor or a mentee, please contact Sally Harrison, Clinical Program Director at (401) 383-9933 or sally@familiesfirstri.org or visit our website, www.familiesfirstri.org.

Members’ Activities John Aflague is a Volunteer for the US Department

of Homeland Security National Emergency Resource. He will now be prescribing as well as providing psychotherapy.

Roberta Feather was recently honored by Butler Hospital as a Partner in Philanthropy and is on their Board of Trustees. Dr. Feather also has a legislative Appointment to the Hospital Merger Committee. And is on the Board of Directors for RICCHMO and on the Board of Trustees for the Providence Center.

Ginette Ferszt will be presenting at the American Correctional Health Services Association Annual Conference (ACHSA) scheduled for March 13-15th in Orlando. The topic of her presentation is Responding to the Needs of Pregnant Incarcerated Women: The Development of Two Programs.

Christina Rosa serves as the PCNS representative on the Rl State Board of Nursing.

Psychopharmacology: Beware of over the counter medications.

The combination of meperidine (Demerol) and dextromethorphan (cough suppressant) are notorious for precipitating acute serotonin syndrome. Serotonin syndrome is often precipitated by medications that are not thought of as being serotonergic.

Caution must be taken with administering serotonergic medications to patients with vascular disease. These individuals should consult the pharmacist or MD before self medicating with over the counter cough medicines. It has been reported that the combination of paroxetine and Nyquil caused serotonin syndrome in an individual with a prior history of vascular disease.

Networking Dinners Diane Roberts has graciously volunteered to

coordinate our networking dinners for the coming year. Information about these dinners is sent via the RISNA PCNS list serve. If you are a PCNS and would like to be added to our list serve please contact RISNA.

American Nurses Association

SILVER SPRING, MD–The American Nurses Association (ANA) is pleased to have three of its books recognized at the 2008 Publications Awards from the Washington, DC, Chapter of the Society for Technical Communication (STC).

“It is an honor to receive this distinguished tribute by STC for ANA’s outstanding works that will no doubt prove to be valuable resources in the nation’s nursing classrooms. I would like to recognize the excellent work of all those involved in producing such fresh and innovative publications that truly underscore ANA’s ongoing commitment to ensuring the delivery of high quality health care to the public we serve,” said ANA President Rebecca M. Patton, MSN, RN, CNOR.

The awards presented were as follows: • Award ofMerit:Nursing Informatics: Scope &

Standards of Practice. • AwardofMerit:Guide to the Code of Ethics for

Nurses: Interpretation and Application, edited by Marsha D.M. Fowler, PhD, MDiv, MS, RN, FAAN.

• Award of Excellence: Nursing and Health Care Ethics: A Legacy and A Vision, edited by Winifred J. Ellenchild Pinch, RN, EdD, FAAN, and Amy M. Haddad, BSN, MSN, PhD.

The STC is the single largest individual membership organization dedicated to promoting technical communication. The Washington, DC, Chapter of the STC holds its Technical Publications Competition annually with its judges and participants in the event representing technology and R&D firms, government agencies and institutes, non-governmental organizations, university presses, and professional associations in the Washington, DC area.

Press copies of the three award winning publications are available to media contacts upon request by e-mailing Cynthia Lee at Cynthia.Lee@ana.org. Please include the name of the publication, organization, reviewer name and address information, including phone number and e-mail address.

ANA Honored with Publishing Awards

Assessment. Currently, she is a member of RISNA’s Environmental Health Committee.

Marcy is an active member in a number of state and national professional organizations, including RISNA, the Rhode Island and American Associations of Occupational Health Nurses, Sigma Theta Tau Delta Upsilon Chapter-at-Large and the American Society of Safety Engineers. She has written a number of peer-reviewed journal articles, co-authored chapters for nursing textbooks and presented at a number of international and national conferences. Marcy has been the recipient of numerous awards and has received several research grants. Her doctoral research will concentrate on current exposure to multiple environmental chemicals among women of childbearing age.

Marcy will be recognized as an FAAOHN at the 2009 AAOHN Symposium and Expo in Orlando in April 2009.

Also being recognized is Anne Brown, RN, BS, COHN-S/CM, who is being awarded with the Northeast Leadership Grant for Rhode Island, sponsored by the Medique Company. Anne has been an occupational health nurse since 1990 and is currently the lead nurse at the Take Care Health Systems Occupational Health and Wellness Center, located at Fidelity Investments in Smithfield. Anne previously worked in a hospital-based occupational health clinic, as well as the occupational health nurse for several employers. She is currently the Vice President of RIAOHN.

This award recognizes one Occupational Health Nurse in each of the 10 northeast states who demonstrates emerging leadership skills. A $300 educational grant is provided as a way of fostering continuing development of these skills. Applicants must have served in volunteer leadership positions in nursing or community-based organizations.

Anne will receive her award at the Northeast Association of Occupational Health Nurses Annual Conference in Atlantic City, New Jersey on March 26, 2009.

Page 10 • Rhode Island Nurse May, June, July 2009

Rhode Island State Nurses Association

Baker-Hanley House67 Park Place WWW.RISNARN.ORGPawtucket, RI 02860 RISNA@prodigy.net(tel) 401-305-3330(fax) 401-305-3332 RISNA MEMBERSHIP ONLY

Date: ______________________________

Last Name/First Name/Middle Initial Credentials License # State

Home Address Home Phone Number Home Fax Number

City/State Zip Code Home Email Address

Employer Alternate Email Address

Title/Practice Setting/Specialty Work Phone

RISNA Membership Benefits

♦ Discounted rate on ALL RISNA Continuing Education Programs♦ RISNA newsletter♦ Direct mailings and/ or emails on RISNA events/programs/activities♦ First hand and accurate information on laws/rules and information pertinent to your profession

Dues for RISNA member only $150.00 annually (make check payable to RI State Nurses Assoc)

Enclosed is also a donation for ___$5.00 ___$10.00 $_____ to the RISNA-PACC to secure Nursings/RISNA’s active participation in RI’s political arena. ***PLEASE NOTE ALL DONATIONS TO RISNA/PAC MUST BE ON A SEPARATE CHECK***

American Express/DiscoverMastercard/Visa _________________________________________ ___________________ Card Number Expiration Date3 Digit Code (from back of card - required)__________ Signature ______________________________________

Do you want to be on the (please check) ____________ NP list serve? ___________ PCNS list serve?

❖ Are you interested in serving on a committee? yes no

❖ Would you like to have a member of the nominating committee contact you to determine your area of interest of running for an elective seat on a committee? yes no as an elected leader? yes no

Preferred way of contact:email ___________________________OR phone number ___________________ (complete if different from above)(This membership option entitles you to all the benefits of RI State Nurses Association only. It does not; however, entitle youto the benefits of ANA)

May, June, July 2009 Rhode Island Nurse • Page 11

8515 Georgia Avenue • Suite 400 • Silver Spring, MD 20910-3492 • (301) 628-5180 • Fax: (301) 628-5355

Last Name/First Name/Middle Initial Home Phone Number

Credentials Work Phone Number Basic School of Nursing

Preferred Contact: Home __________ Work ____________ Fax Number Graduation (Month/Year)

Home Address Date of Birth RN License Number/State

Home Address E-mail

City/State/Zip County ___ UAN member? __ Not a Member of Collective Bargaining Unit

Employer Name Member of Collective Bargaining Unit other than UAN? (Please specify)

Employer Address

Employer City/State/Zip Code

MEMBERSHIP DUES VARY BY STATE(Check with your Constituent Member (State) Nurses Association for rates, or call 1-800-923-7709 from 9 am to 5 pm EST Monday to Friday)

Membership Category (check one)

M Full Membership Dues ❍ Employed - Full-time ❍ Employed - Part-time

R Reduced Membership Dues ❍ Not Employed ❍ Full-Time Student ❍ New graduate from basic nursing education program, within six months after graduation (first membership year only) ❍ 62 years of age or over and not earning more than Social Security allows

S Special Membership Dues ❍ 62 years of age and over and not employed ❍ Totally Disabled

Please Note:

$5.42 of the CMA member dues is for subscription to The American Nurse. Various amounts are for subscriptions to CMA/DNA newsletters. Please check with your CMA office for exact amount.

State nurses association dues are not deductible as charitable contributions for tax purposes, but may be deductible as a business expense. However, the percentage of dues used for lobbying by the CMA is not deductible as a business expense. Please check with your CMA for the correct amount.

Choice of Payment (please check)

❍ E-Pay (Monthly Electronic Payment)

This is to authorize monthly electronic payments to American Nurses Association, Inc. (ANA). By signing on the line, I authorize my Constituent Member Association (CMA)/ ANA to withdraw 1/12 of my annual dues and any additional service fees from my account.

❍ Checking: Please enclose a check for the first month’s payment; the account designated by the enclosed check will be drafted on or after the 15th of each month.

❍ Credit Card: Please complete the credit card information below and this credit card will be debited on or after the 1st day of each month.______________________________________Monthly Electronic Deduction Authorization Signature

*SEE BELOW❍ Full Annual Payment Membership Investment ___ ANA-PAC (Optional–$20.04 suggested ___ Total Dues and Contributions ___

Online: www.NursingWorld.org (Credit Card Only)

❍ Check (payable to ANA) ❍ VISA ❍MasterCard

CREDIT CARD INFORMATION

____________________________________Bank Card Number and Expiration Date

____________________________________Authorization Signature

____________________________________Printed Name

Amount: $ ___________

❍ Automated Annual Credit Card Payment

This is to authorize annual credit card payments to American Nurses Association, Inc. (ANA). By signing on the line, I authorize CMA/ANA to charge the credit card listed in the credit card information section for the annual dues on the 1st day of the month when the annual renewal is due.

_____________________________________Annual Credit Card Payment Authorization Signature

*SEE BELOW❍ Payroll Deduction This payment plan is available only where there is an agreement between your employer and the association to make such deduction.

_____________________________________Signature for Payroll Deduction

Please mail your completed application with payment to your STATE NURSES ASSOCIATION or to:

AMERICAN NURSES ASSOCIATIONCustomer and Member BillingP.O. Box 504345St. Louis, MO 63150-4345

* By signing the Monthly Electronic Deduction Authorization, or the Automatic Annual Credit Card Payment Authorization, you are authorizing ANA to change the amount by giving the above-signed thirty (30) days advance written notice. Above signed may cancel this authorization upon receipt by ANA of written notification of termination twenty (20) days prior to deduction date designated above. Membership will continue unless this notification is received. ANA will charge a $5 fee for any returned drafts or charge backs.

State NurSeS aSSociatioN MeMberShip applicatioN

TO BE COMPLETED BY SNA Employer Code ________________________

________ __________ _________ STATE DIST REG Approved By _____________ Date ________

Expiration Date _______ / ___________ $____________________________________ Month Year AMOUNT ENCLOSED CHECK#

Sponsor, if applicable _________________________________

SNA membership #____________________________________

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

RISNA/ANA Membership Dues Membership Type Annual Dues

• EmployedFullTimeorPartTime FullMembership $265

• Notemployed• RN&FullTimestudent• Atleast62yearsofageandearningmorethan Reduced $132.50 Social Security Limit Membership• NewGraduateofBasicNursingEducation Program (one year only) • Parttimegraduatenursingstudentattending an accredited nursing program (5 years max)• ParttimeRNstudentinanaccreditedBSN program (5 years max).

• 62YearsofageandNotEmployed Special $66.25• TotallyDisabled Membership

DATE __________________________________________________