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The Newsletter of the American Nurses Association–MaineQuarterly publication direct mailed to approximately 25,000 RNs and LPNs in Maine.
ANA-MAINE
JOURNALSUMMER 2017
President’s Message
Index
By Patricia Boston, MSN, RN, RRTANA-MAINE President
The Serenity prayer has been resonating in my head recently. Most of us are familiar with this prayer, and have seen it on coffee mugs, plaques and other items. According to Wikipedia, the prayer was written by Reinhold Niebuhr, an American theologian, in the 1930s. The prayer has undergone several iterations and the commonly quoted version is:
God, grant me the serenity to accept the things I cannot change,Courage to change the things I can,
And wisdom to know the difference.
Why has this prayer has been resonating? I believe it is as a result of some of the political and social turmoil we are currently experiencing. As I write this message, the future of healthcare in our country is uncertain; the US Senate has delayed their vote until after the July 4th recess. The state of Maine experienced a brief government shutdown as the House, Senate and Governor struggled to reach an agreement on a state budget. The tone of the news media seems less objective in many instances, and coverage of political tweets and social media posts is rampant. My email inbox is flooded with messages requesting that I donate to a cause, contact legislators, or join a protest.
Civil discourse, and the willingness to be open to other points of view and to compromise has been replaced in many venues with a “my way or the
Patricia Boston
The Courage to Changehighway” perspective which perpetuates a negative atmosphere and precludes progress. This prayer, on the other hand, offers us a framework in which to evaluate the many situations wherein we can effect change and exert some control. It guides us to feel powerful and not powerless.
In reality, I believe we take the three steps outlined in the prayer in reverse order. That is, we first use wisdom to discern what we can influence or change and what we cannot. Recognizing what can be changed is important in avoiding frustration and deciding where to focus our efforts. When we do this, we assess the time, talent and treasure that we have available. We prioritize to strike a balance with the commitments and challenges we have in our personal and family lives.
The next step calls for us to display the courage to devise and operationalize action steps. Depending on the issue, we may do this alone or in concert with others. Some issues require a long-term commitment whereas others may require only a one-time action or something in between. We may assume a leading role in some cases and a supportive role in others.
When we exercise wisdom to identify the issues we can change, and show the courage to take action on those issues, then we can accept the serenity that comes from knowing we have done what we can.
Nurses display the courage to make a meaningful difference every day – in big and small ways, with both individuals and groups. This issue of the ANA-Maine newsletter includes many examples of and opportunities for making changes:
• HealthyNurseHealthyNation™which isANA’sinitiative to have nurses focus on and improve their own overall health – so that they might be in their best form to impact the patients and communities they care for, as well to serve as role models for healthy behavior and self-care.
• ChristinaTapleywhoreceivedaDaisyAwardforher initiative in patient care.
• Valerie Fuller who is being recognized for herwork with the Board of Nursing and on behalf of advanced practice nursing.
• Sally Melcher-McKeagney’s connection withthe Alliance of Nurses for Healthy Environments (AHNE) and the work that organization does.
• TheNursingonBoardsCoalition(NOBC)effortsto increase the number of nurses on boards, and reference to Susan Henderson, Samantha Paradis and Anne Perry stepping into the political arena.
• ANA-Maine’s nursing advocacy, includingthe passage of the Enhanced Nurse Licensure Compact, and ANA Hill Day.
• Juliana L’Heureux’s collaboration with groupsaddressing healthcare issues in Maine.
• Joining and participating in ANA and ANA-Maine, an opportunity for all RNs.
There are certainly many other exemplars which could be cited. We are happy to recognize the achievements of our colleagues. It is hoped that the ones included here will cause you to reflect on your own achievements. As I repeat on a regular basis, nursing consistently earns the highest public ranking for professional honesty and ethics. We have frontline experience with many significant issues that affect the lives of those in our communities. We should confidently exert our influence and ability to have a positive impact.
Identify what you can change. Determine how you will actualize the courage to make those changes. And experience the serenity that comes from knowing you have accomplished what you can.
Respectfully,
ANA-Maine Heads to the Hill . . . . . . . . . . 2OMNE/ANA-MaineAnnualMeeting . . . . . 3Christina Tapley, RN Receives Daisy Award . . . 4Board of Directors Election . . . . . . . . . . . . . . . 4Maine Enacts eNLC . . . . . . . . . . . . . . . . . . . . 5Maine Nurses Speak About the Health Care Bill . . . . . . . . . . . . . 6
ValerieFullerReceivesElaineEllibeeAward . . 7Nurses on Boards Coalition . . . . . . . . . . . . . . 7Continuing Education Corner . . . . . . . . . . . . . 8MAT Treatment Education . . . . . . . . . . . . . . .102017: Year of the Healthy Nurse. . . . . . . . . . .10ANHE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11 Membership Application . . . . . . . . . . . . . . . .11
Page 2 ANA Maine Journal August, September, October 2017
Published by theAMERICAN NURSES ASSOCIATION-MAINEa constituent member association of the
American Nurses AssociationE-mail: [email protected]
Web Site: www.anamaine.org
P.O.Box647Kennebunk,ME04043
ANA-MAINE BOARD OF DIRECTORS
Patricia Boston, MSN, RN, RRTPresident, Biddeford
Catherine Lorello-Snow, PMHRN-BCPresident-Elect, Portland
Jean Dyer, PhD, MSN, BSN, CNETreasurer, York
Juliana L’Heureux, BS, MHSA, RNSecretary, Topsham
Robert Abel, BSN, RN, CHPN, CMC, CCMDirector, Saco
Joanne Chapman, MED, MSN, RN, NE-BCDirector, Falmouth
Paula Delahanty, RN, BSN, MHSADirector, Warren
Carla Randall, PhD, RN, CNEDirector, Auburn
Amander Wotton, MSN, RNDirector, Windham
Contents of this newsletter are the opinion of the author alone and do not reflect the official position of ANA-MAINE unless specifically indicated. We always invite leaders of specialty organizations to contribute.
ANA-MAINE EDITORIAL COMMITTEEMichelle L. Schweitzer (Editor)Patricia Boston, MSN, RN, RRT
Jean Dyer, PhD, MSN, BSN, CNEJulianaL’Heureux,BS,RN,MHSA
We welcome submissions, but we reserve the right to reject submission of any article. Send to [email protected]. CE calendar listings are without charge.
Attribution: We do not knowingly plagiarize. We encourage our authors to fact check their material but we do not assume responsibility for factual content of ads or articles.
For advertising rates and information, please contact ArthurL. Davis Publishing Agency, Inc., 517Washington Street, POBox 216, Cedar Falls, Iowa 50613, (800) 626-4081, [email protected]. ANA-Maine 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. Published quarterlyeveryFebruary,May,AugustandNovember.
Acceptance of advertising does not imply endorsement or approval by ANA-Maine 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. ANA-Maine 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 thispublication express the opinions of the authors; they do not necessarily reflect views of the staff, board, or membership of ANA-Maine or those of the national or local associations.
Postal Address corrections: This list of addressees is obtained from the Maine State Board of Nursing (MSBON)each issue. To keep your address current for these mailings, simply notify the MSBON of any needed changes in yourpostal mailing address.
Permission must be obtained from ANA-Maine to replicate or reproduce any content from ANA-Maine Journal.
Volume 13 • Number 3
“Hill Day” precedes the official opening of the ANA Membership Assembly. ANA coordinates this day and schedules visits with our members of the US House of Representatives and Senate to discuss legislative issues of importance to the nursing profession. Maine’s representatives tothe Membership Assembly, Patricia Boston and Catherine Lorello-Snow, visited the offices of Representatives Pingree and Poliquin and the officesofSenatorsCollinsandKing.
Specific legislation discussed included:1. the AHCA. We affirmed ANA’s Principles
for Health System Transformation 2017 which state that the system must: a. ensure universal access to a standard
package of health care services; b. optimize primary, community-
based and preventive services while supporting the cost-effective use of innovative, technology-driven, acute, hospital-based services;
c. encourage mechanisms to stimulate economical use of health care services while supporting those who do not have the means to share in costs; and
d. ensure a sufficient supply of a skilled workforce dedicated to providing high quality health care services.
2. the Registered Nurse Safe Staffing Act, which has yet to be introduced, would require “Medicare-participating hospitals to establish a committee, composed of at least 55% percent direct care nurses, to create nursing staffing plans that are specific to each unit.”
3.Title VIII NursingWorkforce Reauthorization Act(S. 1109/H.R. 959) which is the largest sourceof federal funding for nursing education and includes the following grant programs: Advanced Education Nursing; Workforce Diversity Grants; Nursing Education, Practice, and Retention Grants; the National Nurse Service Corps; the NurseFacultyLoanProgram;andComprehensiveGeriatric Education Grants. We reviewed the projected nursing shortages that Maine will face,
as revealed by the NEONI study, and discussedthat this funding is an important element in resolving that shortage. This bill is cosponsored by Senator Collins and Representative Pingree.
4. the Home Health Care Planning Improvement Act(S.445/H.R.1825),whichwassponsoredbySenator Collins, would allow nurse practitioners, clinical nurse specialists and certified nurse midwives to sign the final care plan to order home health services – which otherwise would require physician certification. Particularly in underserved and rural states, this would allow a more efficient and cost effective process and enhancetheuseofAPRNskills.SenatorKingandRepresentative Pingree are cosponsors of this legislation.
Though Hill Day provides an opportunity to meet in the DC offices of our legislators, they can also be contacted through their state offices - in person, or by phone or email. If you have questions about how to communicate with your state or national legislators, feel free to send a message to [email protected].
ANA-Maine Heads to the Hill
Patricia Boston, MSN, RN, RRT, President; Representative Chellie Pingree; Catherine Lorello-Snow, PMHRN-BC, President-Elect
WHAT WOULD YOU LIKE TO SEE IN THE NEWSLETTER?Do you have an idea for an article or want to
become an author? Is there something going on in your workplace that you would like to share with other nurses? Do you have a suggestion to share about the ANA-Maine newsletter? If so, please contact us at [email protected].
WANT TO STAY CONNECTED?Connect with RNaction.org to be updated on
the latest national policy and legislative issues that affect your work. Go to www.rnaction.org to sign up for emails and to follow @RNAction Tweets.
FollownursingonFacebookontheANA-Maineand American Nurses Association pages.
August, September, October 2017 ANA Maine Journal Page 3
OMNE/ANA-MAINE Annual MeetingNurses: Leading the Redesign of Care Delivery in Maine
September 28 & 29, 2017
In Partnership with
LOCATION: Hilton Garden Inn, Freeport, Maine.Tucked away in the heart of Freeport Village, theHilton Garden Inn Freeport Downtown is your idealdestination among hotels in Freeport, Maine. Onlytwo blocks down the hill from LL Bean® and perfectly situated within walking distance to over 100 upscale retail outlets and boutique shops. Featuring wirelesshigh-speed internet access, 24-hour complimentary business center, and an indoor pool and hot tub.
HOTEL INFORMATION: A block of rooms at the Hilton Garden Inn has been reserved at the special conference rate of $179 per night plus tax good throughAugust28th. For reservations, please call theInn directly at 1-207-865-1433. Register early, rooms are limited.
CANCELLATION POLICY: Registrants who are not able to attend or send a substitute can obtain a refund of their registration fees. A written request must be received by September 15, 2017. REFUNDSWILL NOTBEISSUEDAFTERTHISDATE.
FOR ADDITIONAL INFORMATION: OMNE: Stephanie Budreau at 207-768-4301 or [email protected]. You may also visit www.omne.org.---------------------------------------------------------------------------ANA-MAINE: Michelle Schweitzer at 207-310-1629 or via e-mail at [email protected]. You may also visit www.anamaine.org. ---------------------------------------------------------------------------
REGISTRATION FEES___________________________
NOTE: Conference fee includes continental breakfast, lunch, breaks and dinner (optional).___________________________
OMNE and ANA-MAINE Members:
oDay1Only–$100
o Day 1 and Dinner – $135
oDay2Only–$60
oFullProgramOnly–$150
oFullProgram&Dinner–$185___________________________
NON Members:
oDay1Only–$115
o Day 1 and Dinner – $150
oDay2Only–$75
oFullProgramOnly–$180
oFullProgram&Dinner–$215___________________________
STUDENT:
oOneDayRate–$40
*Does not include dinner___________________________
ALL
oOMNE/ANABusinessMtg–Free
oDinnerOnly–$35___________________________
MAIL: StephanieBudreau,OMNEAdministrativeAssistant The Aroostook Medical Center P.O.Box151 Presque Isle, ME 04769
Please make check payable to: OMNE
ONLINE: www.anamaine.org
Name: ______________________________________________________________
Home Address:_______________________________________________________
City/Town: ____________________________ State: _______ Zip: _____________
Credentials: ____________________________ Phone: _______________________
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REGISTRATION Register Early, Space is Limited
Keynote Speaker:
Dr. Dora Mills, MD, MPH, FAAP
VicePresidentforClinicalAffairs,DirectorCenterforExcellenceinHealthInnovation,InterimVicePresidentforResearchandScholarship,UniversityofNewEngland
Vendors • Networking • Presentation of the Agnes Flaherty Leadership Award and Sister Consuela White Spirit of Nursing Award
Visit us online:www.omne.org&www.anamaine.org
OMNE/ANA-MAINE Annual Meeting General Information
This activity has been submitted to the Northeast Multi-State Division for approval to award contact hours. The Northeast Multi-State Division is accredited as an approver of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation. Maine, New Hampshire, New York, Rhode Island, Vermont Nurses Associations are members of the Northeast Multi-State Division of the American Nurses Association.
A smile is a part of our uniform! Come and work with my team. We need RNs, LPNs, & CNAs.
Per diem rates $29 for RNs, $24 for LPNs, and $15.25 for CNAs. Plus Shift Differentials. WEEKLY PAY.
Apply online: www.BrentwoodCenterRehab.comKim Duest, Director of Nursing Services,
[email protected] | 207-846-9021 ext. 11
Friday, September 29, 2017 | 9am – 4pm
University of Southern Maine – Portland campus, Abromson Center
Registration: $50/$25 students | Includes lunch and parking
FMI and to register: visit usm.maine.edu/muskie/patient-safety-academy
Open to anyone interested or engaged in patient safety activities. Workshops include skill-building and best practices in the areas of patient
engagement, infection prevention, opioid education, falls prevention, antibiotic stewardship, patient safety culture, health literacy and ethics.
8th Annual Patient Safety Academy
Page 4 ANA Maine Journal August, September, October 2017
ANA Adopts Bylaw Changes at the
Membership AssemblyAtthisyear’sMembershipAssembly,heldJune9–10
in Washington, DC, the following bylaw changes were approved:
1. Reauthorization of the Membership Assembly meeting format – which replaced the House of Delegates for an interim period through 2017 – but with an increase to 200 representatives. This bylaw amendment, which required a 2/3 approval vote,was a compromise measure offered by the ANA Board.SeveralC/SNAshadproposedareturntotheHouse of Delegates format with 400 delegates.
2. Approval for ANA to pursue formally ending its status as a labor organization and amending related wording. The change in status will allow ANA greater ability to pursue opportunities for generating non-dues revenue. ANA provided reassurance that it “remains steadfast and committed to the right of nurses to engage in collective bargaining to improve their working conditions. While ANA does not engage with employers in collective bargaining, either directly or indirectly, it supports the rights of C/SNAs toengage in a wide range of activities including collective bargaining, workplace advocacy and political advocacy, as tools for RNs to improve their working conditions. We have not altered our beliefs.” This change in status cannot be finalized until there is significant legal input and review.
3. Amended the name of the Reference Committee to the Professional Policy Committee.
4. Amended language to reflect that only RN members of a C/SNA are eligible for ANAmembership. This language was necessary as someC/SNAsmaychoosetoallownon-RNstobemembers of their individual organizations.
5. Amended language related to the role and responsibilities of the ANA president and board of directors; the ability to conduct virtual meetings; the timing of submission of proposed bylaw changes; and Membership Assembly meetings.
Christina Tapley, RN Receives Daisy AwardCongratulations to Christina
Tapley, RN, recipient of the Daisy Award in May, 2017. The Daisy Award is given in memory of J. Patrick Barnes.
Christina’s spotlight isshared below from www.daisyfoundation.org:
Christina Tapley, RNMS4Southern Maine Health CareBiddeford, Maine
My mom was a patient and upon discharge, her doctor explained that she would be on an antibiotic for several more days and would send the antibiotic
to the assisted living facility. Her nurse handed me an envelope, which I assumed had the antibiotic prescription and we left. Once we arrived at theassisted living facility, I handed the packet to the staff.
Mymom’sdoctorcalledmethateveningtotellmethat SMHC had forgotten to include the prescription in the packet and that one of the nurses offered to run over several doses of the antibiotic to the rehab facility until they could have it filled the following Monday.
My mom was admitted again recently and her physician told me who the nurse was who did this extraordinary thing for my mom. She did not know my mother nor was she her nurse at the time, but she knew how important it was that my mom had her antibiotic. I have had several interactions with Christina and her obvious compassion always stands out. She is a remarkable nurse.
Polls will be Open August 22 – September 21ATTENTION ANA-MAINE MEMBERS!
VOTE! VOTE! VOTE! VOTE! VOTE! VOTE! VOTE!
This is the third year that ANA-MAINE is utilizing the secure online voting system to elect members to fill open positions on the board. Nomination submissions were accepted through July 18 and the electronic ballot will be available August 21 – September 21.
Positions to be filled are:
Position TermPresident-elect 2 YearsTreasurer 2 YearsDirector 2 YearsDirector 2 Years
As a member of ANA-MAINE, you have the opportunity to determine the leadership of our organization. Details about the electronic voting process will be emailed to members and may be found on our website at www.anamaine.org.
ANA-MAINE eagerly anticipates the activities planned for the next work year. Your vote in this process is a way to positively affect the continued work of your organization.
To request a paper ballot, please call the ANA-MAINE office at 207-310-1629.
Deadline for online voting is September 21, 2017
The newly elected board of directors will be announced on September 28, 2017 at the ANA-MAINE annual business meeting. More details regarding this event may be found at www.anamaine.org
Christina Tapley, RN displays her Daisy award with her colleagues at Southern Maine Health Care in Biddeford, Maine.
You’ve always dreamed of being a nurse.
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nursingALD.comFREE to Nurses!
August, September, October 2017 ANA Maine Journal Page 5
Maine Enacts Enhanced Nurse Licensure Compact (eNLC)
Reprinted with permission from NCSBN
Media Contact: Dawn M. KappelDirector, Marketing & Communications
312.525.3667 direct | 312.279.1034 fax | [email protected] CHICAGO – Maine has joined Arizona, Arkansas, Florida, Georgia, Idaho,
Iowa, Kentucky, Maryland, Mississippi, Missouri, Montana, Nebraska, NewHampshire,NorthDakota,Oklahoma,SouthCarolina,SouthDakota,Tennessee,Texas,Utah,Virginia,WestVirginiaandWyomingasamemberoftheeNLC.
Allowing nurses to have mobility across state borders, the eNLC increases access to care while maintaining public protection. The eNLC, which is an updated version of the current NLC, allows for registered nurses (RNs) and licensed practical/vocational nurses (LPN/VNs) to have one multistate license,with the ability to practice in both their home state and other NLC states. The eNLC will come into effect the sooner of 26 states enacting the eNLC or Dec. 31, 2018. All states, including those participating in the existing NLC, must introduce legislation in the coming years to enter into the enhanced NLC.
“Maine has been a member of the compact for 17 years. Adoption of the eNLC ensures that our licensees have mobility across state borders using their multistate licenses as well as improving access to care and maintaining public protection,” comments Valerie Fuller, DNP, PhD, AGACNP-BC, FAANP, MaineState Board of Nursing president.
Patient safety being of paramount importance led to the addition of new features found in the provisions of the legislation of the eNLC. Licensing standards are aligned in eNLC states so all nurses applying for a multistate license are required to meet the same standards, which include a federal and state criminal background check that will be conducted for all applicants applying for multistate licensure.
The eNLC enables nurses to provide telehealth nursing services to patients located across the country without having to obtain additional licenses. In the event of a disaster, nurses from multiple states can easily respond to supply vital services. Additionally, almost every nurse, including primary care nurses, case managers, transport nurses, school and hospice nurses, among many others, needs to routinely cross state boundaries to provide the public with access to nursing services, and a multistate license facilitates this process.
Boardsofnursing(BONs)werethefirsthealthcareproviderregulatorybodiesto develop a model for interstate practice with the original adoption of the NLC in 1997 and its implementation in 2000. While other health care provider regulatory bodies are just getting started in this process, the NLC has been operational and successful for more than 15 years.
Additional information about the eNLC can be found at www.nursecompact.org.
About NCSBNFounded March 15, 1978, as an independent not-for-profit organization,
NCSBN was created to lessen the burdens of state governments and bring together boards of nursing (BONs) to act and counsel together onmatters ofcommon interest. NCSBN’s membership is comprised of the BONs in the 50states, the District of Columbia, and four U.S. territories – American Samoa, Guam, Northern Mariana Islands and the Virgin Islands. There are also 27associate members that are either nursing regulatory bodies or empowered regulatory authorities from other countries or territories.
NCSBN Member Boards protect the public by ensuring that safe and competent nursing care is provided by licensed nurses. These BONs regulatemore than 4.5 million licensed nurses.
Mission: NCSBN provides education, service and research through collaborative leadership to promote evidence-based regulatory excellence for patient safety and public protection.
The statements and opinions expressed are those of NCSBN and not the individual member state or territorial boards of nursing.
Page 6 ANA Maine Journal August, September, October 2017
Maine Nurses Speak About the Health Care BillJuliana L’Heureux, BS, MHSA, RN
LEWISTON, ME – A press conference was heldat Lewiston’s Central Maine Medical Center, in theclassroomoftheFamilyResidencyprogram,onJune23, where Jaime Johnson, R.N., spoke from personal experience about the impact of potential health care cuts to children and those receiving Medicaid coverage. She is a labor and delivery nurse who lives in Auburn, Maine.
She spoke at the press conference led by the Maine Providers Standing Up for Healthcare, a grassroots advocacy group of physicians, nurses, social workers and healthcare consumers.
Although the proposed health care legislation is a daunting Congressional debate, the circumstances Johnson described in her testimony represented the dilemma faced by millions of people who have been challenged by critical situations and distressed by the public health policy debate.
In her public testimony, she said her 9-year career as a nurse included having worked in three different predominantly poor and underserved communities across the eastern United States. “I have seen firsthand the effects of perpetuating poverty and illness through poor access to health care and inadequate education, but I’m not only speaking asanurseandhealthcareprovider.I’malsohereasthemother of a child with a chronic illness.”
This is her testimony about her son who is being treatedforTetralogyofFallot:
I could stand here and talk about statistics and quoteexactnumbers,but that’sbeendonealready.My day-to-day life is not about statistics. It’s aboutmybeautifulson,Fin.
My son Finley has endured three open heartsurgeries in his 7 years of life. The most recent was this past April. It put him in the hospital for the longest week of his life, caused him to miss over a month of school, and has left him emotionally fractured. But hisbattle is far fromover,as there isnocure forFin’scongenital heart disease. This last procedure was just another extension guaranteeing that he will need another surgery within the next 10 years.
From themoment he was born, Fin was a “pre-existing condition” and he will be one for the rest of his life. He is one of 229,000 Mainers to bear such an illness title. Yet, I am acutely aware that he is one of the “privileged” because his parents are able to provide him with access to healthcare that they can afford and are able to take him to the best doctors in the world for his specific condition.
We have representatives that contend that healthcare is not a right. Some have even stated that “nooneeverdiedbecausetheydidn’thaveaccesstohealthcare.” I am here to put a face to the people for whom affordable healthcare access is their only path to their right to life.
There are two specific things that concern me most about the potential new healthcare law. The first is allowing insurance companies to charge higher premiums for patients with pre-existing conditions. And the second is the enormous proposed cuts to Medicaid.
Denyingachild likeFinleyaffordablecoverageforhis congenital heart disease would be tantamount to denying him the right to life. Placing him in a high risk pool where the costs to insure him would increase astronomically for his parents would force choices to be made in his care that could likely delay proper treatment or extend waiting periods between necessary procedures.
No, this may not kill my son immediately, but it could, in the end, cost him years of life.
We know from Congressional Budget Office(CBO)analysisthatcurrentlyproposedlegislationwillleave 23 million more Americans uninsured. I want you to know that 40,000 children are born with a congenital heart defect in this country each year. And, if 6 percent fewer Americans are going to have health insurance because of the proposed law and imposed cuts, then 2,300 children with congenital heart disease will be born without insurance each year. This means parents of these children will have to make impossible choices because of politicians’priorities.
Now, one may ask, “But what about Medicaid?” Isn’tthecorepurposeofthisprogramtoprotectthemost vulnerable among us? This is certainly what the program is designed to do, but the proposed American Health Care Act (AHCA) will cut billions of dollars out of Medicaid over the next 10 years; and amending the bill, to postpone the cuts by several more years, does not change the outcome. So, if a
programsoblatantlyfailstoprotectchildrenlikeFin,then it has failed, entirely.
Therefore, I am speaking out to put a face to the chronic illness and to speak about my concerns for mothers of children with chronic illness and disability. I hope that when the Congress and our Senators vote on health care, that they will close theireyesandseeFinley’sfacebeforedecidingwhatthey will do.
Jamie Johnson R.N., (pictured right) is a labor and delivery nurse who spoke at a press conference held on June 23 at CMMC in Lewiston’s Family
Residency program. She joined Dr. Connie Adler, of Farmington ME, with Maine Providers Standing Up for Healthcare, a grass roots advocacy group
that sponsored the event.
ANA-ME CELEBRATED NURSES WEEK AT FENWAY
The Boston Red Sox hosted a special evening honoring Nurses Week on May 3rd. A few from Maine joined fellow nurses from Massachusetts, one of whom sang the national anthem, and Rhode Island to watch the Red Sox beat the BaltimoreOrioles4–2onachillyevening. Maine “got the memo” late but will be looking for this occasion next year to coordinate a group event.
Left to right: Michelle Schweitzer, Director of Business Administration; Patricia Boston,
President; Juliana L’Heureux, Secretary
Patricia Boston, ANA-MAINE President and Donna
Policastro, ANA-MAINE Executive Director
August, September, October 2017 ANA Maine Journal Page 7
Kim Esquibel, PhD, MSN, RNExecutive Director, Maine State Board of Nursing
The National Council of State Boards of Nursing Inc. (NCSBN) will recognize its dedicated and exceptional membership and guests at its annual awards ceremony during the NCSBN Annual Meeting and Delegate Assembly, held in Chicago, Aug. 17, 2017. Valerie J.Fuller, PhD, DNP, AGACNP-BC, FNP-BC, FAANP, board president, Maine StateBoard of Nursing, will receive the Elaine Ellibee Award that is granted to a member who has served as a board president within the past two years, has made significant contributions to NCSBN and demonstrated leadership at the local level as the president.
Dr. Fuller’s most notable contributions are in theservice to professional organizations that influence APRN policy, legislation and regulation. At the local and regional level, she served as president and board member of the Maine Nurse Practitioner Association (MNPA) where she was successful in passing key legislation of importance to NPs. During her tenure as president of MNPA, it became clear to her that APRNs in the state needed to assume a more active role with the Board of Nursing (BON) and the regulatory issues affecting practice. In2008, she developed and submitted a model for an APRN Advisory Committee to the BON. The purposewas to provide a method of interacting with the BONon APRN issues, to offer guidance on the education, certification, licensing and accreditation of APRNs, and promote dialogue amongst the groups. In March of 2009, the BON overwhelmingly approved her requestfor an APRN Advisory Panel. At that meeting, the Board President stated that it was “a significant, if not to the board, monumental day” for the BON and APRNs inthe state. She was recognized at that meeting and other APRN meetings in the state for her work in creating the committee and leadership she provided.
In 2010, she was appointed by the Governor to serve as theAPRNrepresentative totheMaineBONwhereshe iscurrently serving in her third term as Board President.
In 2015, she helped lead the charge to bring Maine into full alignment with the APRN Consensus Model. This included serving as the local expert, drafting language for the bill (LD 970), providing testimony, and contacting state legislators. The bill passed successfully through the senate before being defeated by a small margin in the house.
Dr. Fuller remains deeply committed to helping statesalign with the APRN Consensus Model. She will continue her work with the NCSBN, the BON and other APRNgroups to ensure that all APRNs are able to work to the full scope of their education and training and to improve patient access to safe, high quality and effective healthcare. In her home state, she has provided education on the model to numerous RN, APRN and physician groups including the Organization of Maine Nurse Executives,the Maine Medical Association, the MNPA and the Maine Association of Nurse Anesthetists, to name just a few.
In 2009, she tackled another issue impacting NP practice and patient access to health care. Existing statute only allowed physicians to sign health related forms. After a thorough investigation of the topic, she drafted and submitted legislation entitled “An Act to Streamline Healthcare Services in Maine” (LD 695) to allow APRNs to sign, certify, stamp or endorse medical papers within the APRNs scope of practice. She provided written and oral testimony at the hearing and it came out of committee with a unanimous “ought to pass.” Later that year it successfully passed into legislation allowing state NPs global signature authority.
At the national level Dr. Fuller serves as the StateRepresentative to American Association of Nurse Practitioners (AANP) and has served on three different APRN Committees through the National Council of State Boards of Nursing - the APRN Education Committee, the APRN Consensus Committee, and the APRN Distance Learning Education Committee.
In 2008, Dr. Fuller was one of three students tograduate from the inaugural Doctor of Nursing Practice (DNP) program at the MGH Institute of Health Professions.
One problem she quickly identified was the lack ofsuitable DNP textbooks. Following graduation, she co-authored a textbook on the DNP, integrating all eight of the American Association of Colleges of Nursing (AACN) competencies into one volume. In 2013, her book entitled “DNP Education, Practice and Policy: Redesigning Advanced Practice Roles for the 21st Century” was published. Several colleges have adopted the text for their DNP programs and the book received a 5-starDoody’sBookReview.
Dr. Fuller earned an MS from Boston College, herbasic Family Nurse Practitioner program; a Doctorof Nursing Practice (DNP) from MGH Institute of Health Professions; and a Doctor of Philosophy in Nursing from the University of Arizona. She holds national certification as anAcuteCare, a Family and aGerontological Nurse Practitioner; RN first assist, and a wound/ostomy nurse. Her positions on influentialboards and committees and state representative to the AANP have allowed her great influence in policy and legislative decisions essential to the establishment and maintenance of full practice authority for NPs. In addition, and perhaps one of the most impressive aspects of her career, is her continuous practice as anNP since1995.Dr. Fullerwas recently selected as aHanley Health Leadership Fellow working to improvehealthcare quality and access in the state of Maine. She wasalsoselectedasa2016FellowbytheFellowsoftheAmerican Association of Nurse Practitioners (FAANP),where she joins a group of leaders whose scholarly and forward thinking contributions have led to meaningful improvements to healthcare and the NP role.
In their book “The Leadership Challenge” (2012), Kouzes & Posner write that leadership is more aboutrelationships, about credibility and about what you do. Dr.Fuller’sleadershipinhealthpolicyhasbeensuccessfulin that she has been able to build relationships with a variety of groups to achieve common goals and create change in state, regional and national organizations.
In summary, Dr. Fuller personifies the criteria forselection of the Eileen Ellibee Award. She has made significant contributions to the NP profession as a leader, educator and clinician.
Valerie Fuller Receives Elaine Ellibee Award
Patricia Boston, MSN, RN, RRT
One of ANA’s initiatives is participating in theNurseson Boards Coalition (NOBC), a collaborativewhose goalis to “improve the health of communities and the nation through the service of nurses on boards and other bodies.” Specifically, this coalition aims to have 10,000 nursesonboardsby2020.TheNOBCincludes“corporate,governmental, non-profit, advisory, or governance boards or appointments that have fiduciary and/or strategicresponsibility.”
We have written before in this newsletter about why nurses are well suited to board positions. The nursing process, which we utilize in our everyday work activities, prepares us well. We collect objective and subjective data; clearly define the problem or issue; develop measurable goals and specific plans of action; and conduct an evaluation of the plan’s effectiveness. Thismethodologyallows us to be effective problem solvers in the clinical setting as well as in the board room. We are also well-respected by the public for our professional honesty and ethics.
One avenue to board participation is running forelective office. ANA-Maine does not have data on all nurses who may be local elected officials. We do know that Susan Henderson, MA, RN, former ANA-Maine president and retired nursing professor, currently serves on the South Portland city council, and that Anne Perry, MSN, FNP,istheonlynurseinMaineservingonthestatelevel.Anne, who is a nurse practitioner, maintains an active clinical practice and is the state representative for District 140.
Onenursewho isnowrunningforaposition in localgovernment is Samantha Paradis. She is seeking the mayoral seat in Belfast.
Samantha received a BS in Nursing and a BA in Psychology from the University of Maine. In 2016, she earned a Masters in Public Health from UNE, and is
Nurses on Boards Coalitioncurrently in the Husson University MSN-FNP program.While a high school student, she started working in healthcare as a nursing assistant in a Frenchville nursinghome. She began her professional nursing career as a float nurse at the Mayo Clinic in Rochester, MN, and is currently a staff nurse at Waldo County General Hospital.
Samantha was active in the National Student Nurse Association as a member of the Resolution Committee and as a Candidate for Director East. She participated in the Maine NEW (National Education for Women) Leadership program which was “developed to address the under-representation of women in politics, and designed to educate and empower young leaders by giving them the skills necessary to become the next generation of effective civic and political leaders.” Samantha was a 2016 Global ImpactFellowforUnite forSight inGhana,WestAfrica. She is also a graduate of Emerge Maine, a training program that teaches Democratic women to run and win.
In discussing the campaign with Samantha, she is clearly organized. After graduating from Emerge and speaking at a rally with Congresswoman Chellie Pingree and Senator Bernie Sanders, she began building her “kitchen cabinet,” which consists of campaign manager Jensen Cook, an Emerge classmate, and other community leaders.
Samantha also has developed her campaign strategy. She developed a website – paradisforbelfast.com – to communicate with voters. She also spends time knocking on doors and listening to voters speak about the issues and concerns that are important to them. She says she appreciatesthe“privilegeofseeingaglimpseintopeople’slives” and states it has been “such a learning experience.”
The platform for Samantha’s campaign is based onthe concept of “Health in All Policies” which the Public Health Institute describes as “a collaborative approach to improving the health of all people by incorporating health considerations into decision-making across sectors and policy areas.” This loops back to the NOBC statement
about their ultimate goal of improving the health of communities and the nation.
We will follow Samantha’s campaign with interest.Elected office is, however, only one of many paths to boardmembership.Opportunities for boardmembershippresent themselves at many levels. Your journey may begin with joining a committee with a civic or professional organization, learning the operations of such groups, making connections and developing networks, and expanding and gaining confidence in your abilities. There is an enormous talent pool within our nursing profession. It is inspiring to see some successful role models serve in these strategic roles. Nurses should be at every discussion table where we can help improve the health of our communities. If the idea of board service appealstoyou,youcanfindresourcesontheNOBCsite,nursesonboardscoalition.org or contact ANA-Maine at [email protected].
Page 8 ANA Maine Journal August, September, October 2017
Robin Gilbert, MSN, RN, CEN, CPEN, ANA-Maine Nurse Planner
When nurses are looking to attend education one of the frequently asked questions by attendees is “Are CEs provided with this education?” The CE application and approval process can be confusing, and there are new updates that everyone should be aware of.
Let’sstartbyclearingupsomebasics.1) What is the difference between Accredited Approver Unit vs Approved
Provider Unit for CE?a. Accredited Approver Unit
i. NE-MSD is an accredited approver of continuing nursing education by the ANCC commission on Accreditation serving the northeast region.
ii. To be eligible for accreditation as an Approver Unit the following are criteria:1. Be identified and operate separately as an AU within an eligible
organization:ConstituentorStateNursesAssociation(C/SNA)oftheANA,FederalNursingService(FNS),orSpecialtyNursingOrganization(SNO);
2. Be able to apply ANCC accreditation criteria to applicants accurately, consistently, and reliably;
3. Be administratively and operationally responsible for all aspects of the review;
4. Have the infrastructure in place to operate as an AU; and5. Be in compliance with all applicable federal, state, and local laws and
regulations that affect the AU’s ability tomeet ANCC accreditationcriteria.
6. An approver unit must have a Nurse Peer Review Leader who meets the criteria specified by ANCC
iii.Approver Units within C/SNAs and FNSs may approve both otherorganizations that provide CNE activities (Approved Providers) and Individual Activity Applicants that provide CNE activities. Approver Units withinSNOsmayapproveonlyIndividualActivityApplicantsthatprovideCNE activities.
b. Approved Provider Uniti. An approved provider may be an individual, institution, organization or
agency responsible for the development, implementation, evaluation, financing, record keeping and quality of continuing nursing education activities. Rather than submit an application for a single event, you submit an application to become a provider of continuing education. An approved provider is authorized to independently award contact hours for continuing education for their organization through adherence to ANCC standards.
ii. Examples of provider units may be: university, community college or patient care facility. A commercial interest organization cannot be an approved provider.
iii. A provider unit must have a Primary Nurse Planner who meets the criteria specified by ANCC
iv. An approved provider may award contact hours for an unlimited number of educational activities during its three-year approval period. Approved providers may NOT approve continuing education for otherentities.
v. Target the majority (>50%) of its CNE activities to nurses in a single HHS region and its contiguous states (based on the HHS regions: http://www.hhs.gov/about/agencies/regional-offices). Applicants whose target audience is in multiple regions or in states that are not confined to a single region and its contiguous states for more than 50% of its activities may not be Approved Providers. Instead they must apply to ANCC as Accredited Providers through the accreditation process;
News from ANCC regarding CE (Please see additional information for the following on the NE-MSD website)
• 2015 ANCC Revisions to Conflict of Interest and Bio DocumentationRequirements
• Nodurationrequirementforeducationalactivities
NE-MSD Highlights & Updates • Individual Education Activity (IEA) Application Criteria Update
o NEW IEA application. Please do not use any previous saved formats. Old criteria application submission will not be allowed. Always download a new application from the website to ensure you have the current version and requirements. Do not use saved file copies of previous applications as items change to meet current ANCC and NE-MSD requirements
o New Post Activity Requirements• Approved Provider Updates
o Approved Provider Intent to Apply – NEWo Approved Provider Application Instructions Guide for Writing the
Application and Self Study – NEW o Approved Provider Application – Self Study Criterion – NEWo ApprovedProvidedActivityPlanningForm–NEWo EducationalPlanningTable/Agenda–NEWo ConflictofInterestForm–NEW
Nurses met Maine’s first lady for tea at the Blaine House on Nurses Day in Augusta. Left to right: Myra Broadway, Karen Mueller,
First Lady Mrs. Ann LePage, Ann Sossong, and Juliana L’Heureux
Nursing Ambassadors – Center for Nursing Innovation
Juliana L’Heureux, ANA-ME Secretary, enjoyed a creative evening in FalmouthwiththeSaintJoseph’sCollegeNursingInnovationambassadors.Theydiscussedthefuture of nursing education with Jeanne Arnold, who leads the group to grow the Innovative Nursing Program on the campus at Saint Joseph’s College in Standish,Maine. For more information about the Center for Innovative Nursing at SaintJoseph’sCollege,pleasecontactJeanMaginnis,[email protected]
Nursing innovation ambassadors met in Falmouth, ME to discuss the exciting future and vision for education planned at Saint Joseph’s College on the
Standish Campus. Left to right, back row: Jean Maginnis, SJC Senior Director of Advancement, Jean MacBride, Diane Atwood, Amy Landry, Jennifer
Morris, Joanne Bean, SJC Chief Advancement Officer. Left to right, front row: Cynthia Murray-Beliveau, Meredith Tipton, Jeanne Donlevy Arnold,
Melissa Dlugos, Juliana L’Heureux.
Continuing eduCation Corner
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August, September, October 2017 ANA Maine Journal Page 9
University of Maine Augusta Senior Celebration Class of 2017Juliana L’Heureux, BS, MHSA, RN
AUGUSTA, ME – A nursing heroine from the past wrote about the challenges of advancing nursing practice, in a letter where she described how mandatory licensing became a reality, in 1959, in the Maine legislature. This letter was the topic of my guest speaker’ssubject,presentedonMay10,at theUniversityofMaineatAugusta (UMA)Senior Celebration.
A Nightingale Ceremony with candles was held on the UMA lawn, to culminate the successful Senior Celebration for the Class of 2017, at the UMA campus, when 28 Registered Nurse graduates were awarded the Bachelor of Science degrees, after successfully completing their courses for this academic achievement. Nursing leaders Dr. Lynn King, DNS, RN, Professor, and Dr. CoreyClark, PhD, RN, AHN BC, RYT, Associate Professor, led the program. “Weareveryproudofourstudents’achievements,”saidClark.
A receptionwasheld in theKlahrCenterClassroom,before theprogram began, to showcase an impressive series of academic poster presentations created by the graduating students. Among more than a dozen subjects included in the presentations were posters describing safe nursing practices and the care of HIV infections inprisons.
As a guest speaker, it seemed appropriate to acquaint the future nursing leaders with a colleague from the past. Josephine Philbrick was an Augusta nurse leader who demonstrated courage during challenging times, during the 1950s, when nurses were fighting to achieve mandatory licensure to practice. The standard to practice as a licensed Registered Nurse was mandated in 1959, but only became official after an extraordinary public policy exercise, described in a letter Philbrick wrote after the process achieved its goal. Thankfully, her detailed letter is an example to nurses today and in the future about the importance of supporting quality nursing education.
Josephine Philbrick was past president of the Maine State Nursing Association in 1959.
In 1989, the MSNA dedicated the 75th program publication to the memory of Josephine Philbrick. She held the distinction of having been in the position of president of the MSNA for twenty years. She pioneered many of the programs and collaborations with other associations and established the first MSNA office in 1964, in Augusta. “Jo” had a way with words, directing powerful messages to the membership. In addition to giving consistent and effective leadership in the development of professional nursing, “Jo” also founded the Blood Bank at Eastern Maine General Hospital and pioneeredtheextensionofnursing’sroleinhealthcarepolicy.
Josephine Philbrick died on December 6, 1986.In a letter found in the archives of the Howard Gotlieb Archival
Research Center (archives.bu.edu) at Boston University, Philbrick detailed in a three page typed single spaced narrative about how the law to enforce mandatory registration of nurses was passed, but was then recalled. It wasaheroicefforttoovercomethisunexpectedsetback.Opponentsofthebillwanteditamended to include a “grandfather clause” for those already working but who were not registered; but this provision was opposed by the nurses.
She wrote, “our brief moment of triumph was destined to be short lived. Late that same day, a (state senator) held a closed caucus, at the adjournment of which he announced that the nursing bill was being recalled. This senator has worked with the Maine Medical Association opposition all the way and has been adamant in attaching a grandfather clause, at least in groundwork. Actually, (the senator) did nothing about introducing such a clause during the readings in both houses. We did not know what hislineofattackwas...butwedidknowitwasn’tgood.WefeltverycertainthatifhesucceededinrecallingtheLD1339,wewouldprobablyhave‘thebattleoftheMarne’tofight all over again, and it just seemed as though this was the ultimate straw. We were given to believe that the recall vote would be taken in the Senate when it convened the next morning, and we knew that we would have to work fast. What we did was to put our telephone chain around the state into action, asking the legislative committees in the four corners to have the nurses who had made the original contacts with the various senatorstosendthemanightletter.Ourguidelineforthistelegramwasthis:
“Nurses strenuously opposed to a grandfather clause in the interest of safe nursing practice. Please do everything in your power to prevent such an amendment being added to LD 1339.”
Philbrick’s 1959 narrative transcribed here: At one and the same time, we asked every nurse who could be released from duty to
get to Augusta the next morning and lend her presence to the Senate Chamber. At 11PM that night, word came from Augusta, that the leader of the minority group
in the House had had her hackles up and was moving heaven and earth to prevent a recall. So, also, Dr. Bates, the seasoned member of the Public Health Committee. (who was aligned with the nurses). We were also informed that many of the veteran legislators felt that a recall was highly irregular and a “blow below the belt,” and mincing no words in stating how they felt.
We were told that recall votes were not well tolerated in the Maine legislatures and never with a bill that had come out of committee with a unanimous “ought to pass” and proceeded through both houses with the affirmative vote. All of this gave us fresh impetus in opposing such a move.
The next morning with the dawn, nurses were moving toward Augusta from all quarters and were on hand before the legislature convened to talk with senators themselves. The climate was tense.
Scheduled morning routine took precedence but at 11:00 am, the President of the Senate called for the vote on LD 1339, after hearing the evidence of the state senator (which was the grandfather clause). There were three week “ayes” and a strong surge of “nays.” That concluded any effort to recall LD 1339. This time, Senator Lord (our sponsor) declared that she would take the bill to the Governor herself, and this she did. At the appointed hour, Governor Clauson added his signature to the document, with his backdrop of nurses as pre-arranged.
I should have added that the timing of the telegram was perfect. Just before the redraft was presented in the Senate, a stack of telegrams were brought in by the pages and distributed to the various senators.
I had to be at the Augusta House most of the following day and evening for the annual meeting of the Maine Health Council. Dr. Leonard Scheele was our featured speaker and his appearance
drew a large representation from all the health allied professions (approximately 200 people). Repercussions on LD 1339 and its abortive recall attempt were inevitable. I was approached from all sides, and the buzzing was pregnant with over-tones and undertones relative to the nursing bill. Most of it was good, but there is still a great deal of unhappiness among the Maine Medical Association and the Maine Hospital Associationranksthatthenurseshavewonoutagain.Allinall,it’sbeenatremendouslearningexperience,onethatIwouldn’thavewantedtomiss.IthinkIechothemajorityof those who have carried the ball when I say this.
Fast forwardahalf centuryandwehavewitnessed thevision inPhilbrick’sexcitingand successful experience. In my speaking notes, I re-echoed the brilliant sentiments of nursing leader Josephine Philbrick. In expressed praise for Philbrick’s leadership, I wasproud to recognize how her words resonated as vibrantly with graduating students in 2017, as they did in 1950, among the nurses who advanced practice standards while being challenged by the status quo.
University of Maine at Augusta graduating student Sarah DeWitt heard about nursing leaders of
the past at the Senior Celebration on May 10 at the seminar held to recognize their academic
achievements.
Josephine Philbrick
Dorothea Dix Psychiatric CenterStaff Nurses-Hospital Nurse II
Dorothea Dix Psychiatric Center is seeking motivated and qualified Nurses to fill fulltime vacancies.
As a member of a state wide community of care givers, DDPC collaborates with individuals with severe and persistent mental illness and their community and personal supports to provide recovery oriented, respectful, compassionate, and effective psychiatric care and treatment in the least restrictive, safest, and most therapeutic environment we can create.
Staff Nurse - Hospital Nurse II ($29.54 to $35.24/Hour)(Includes: Base Salary of $18.94 to $24.64/Hour
Plus $10/Hour Stipend & $0.60/Hour Direct Care)Applicants must have a Bachelor’s Degree in Nursing or related field, -OR- graduation from an
accredited school of nursing plus one year of professional nursing experience AND a license as a Registered Nurse as issued by the Maine State Board of Nursing.
Shift & Weekend Differentials Available
Benefit Package Includes: State-Paid Health & Dental Insurance (Value: $419.32 biweekly), Maine State Retirement
System (Value: 15.12% of Salary), Twelve Paid Holidays, Sick Leave, Vacation Benefits, Student Loan Reimbursement Program
To apply, please submit a state of Maine direct hire application that can be found at www.maine.gov/dhhs/jobs, a resume and cover letter to [email protected]. For further information please contact Tamra Hanson, HR Manager at (207) 941-4431.
AAE/EOE
The Pleasant Point Health Center serves the Native American population in the Passamaquoddy Tribe’s on the Pleasant Point Reservation and service delivery area, the southern half of Washington County, Maine. The Nurse Case Manager serves as a patient advocate and liaison and assures that each patient receives quality and timely care and follow-up from in-house and external medical care providers. The Nurse Case Manager works cooperatively with the Health Center Medical Staff.
N U RSE C ASE MANAG E R
The Pleasant Point Health Center is seeking a qualified and licensed applicant for the position of Nurse Case Manager.
Please call our Personnel Dept. at 207-853-2600 x 278 for an application.
Also, please provide a CV and/or Résumé, and 3 (three) letters of reference.
Page 10 ANA Maine Journal August, September, October 2017
YEAR OF THE HEALTHY NURSE CALENDAR
MONTH TOPIC
January • Worksite Wellness
February • Cardiovascular Health
March • Nutrition
April • Combatting Stress
May• Women’sHealth• NationalFitnessandSports
Month
June• Men’sHealth• Cancer Awareness• Skin Health
July • Healthy Sleep
August • Happiness
September • Recovery • Work-Life Balance
October• Infection Control • Immunizations• MoralResilience/Moral
Distress
November • Mental Health • Wellness
December • HealthyEating/HealthyHolidays
In recognition of the impact that increased nurse health, safety, and wellness has on patient outcomes, quality of care, and overall nurse satisfaction and quality of life, American Nurses Association (ANA) has designated 2017 as the “Year of the Healthy Nurse” with the tagline of “Balance your life for a healthier you.” Each month will highlight various health, safety, and wellness topics important not only to nurses, but to their co-workers, families, patients, and the communities in which they live, work, and play. Nurses struggle with multiple health, safety, and wellness challenges. ANA’s 2016 Health Risk Appraisal shows alarming trends for registered nurses (RNs) and nursing students:
• AnaverageBMIof27.6(overweight)• 12% have nodded off while driving in the past
month• Only16%eattherecommendeddailyamountof
fruits and vegetables• Lessthanhalfperformtherecommendedquantity
andtimeofmuscle-strengtheningexercises(ICG&ANA, 2016)
RNs continue to rate workplace stress as a hazardous occupational risk well above the national average (ICG &ANA,2016).Yetnurses’verycalling,professionalism,and strong sense of ethics demand that they become better role models, advocates, and educators.
2017 brings a focus on the Year of the Healthy Nurse, and will include the launch of the Healthy Nurse, Healthy NationTM Grand Challenge (HNHN GC) and the continuation of #FitNurseFriday. ANA’sHNHNGC is asweeping social movement to increase the health of the United States’ 3.6 million RNs, thereby impactingand improving the health of the nation. HNHN GC
focuses on five fundamental indicators of wellness: rest, nutrition, physical activity, quality of life, and safety. These five wellness indicators are incorporated intoANA’sYearof theHealthyNurse topics toensureRNs receive cohesive messaging and assistance on their journey toward their best health ever!
What you can expect from ANA
Year of the Healthy Nurse resources will include:• Sharablesocialmediagraphics,logo,tweets,and
Facebookposts• Dedicated “Year of the Healthy Nurse”
nursingworld.org webpages filled with resources and events and updated monthly
• ANAmembermessaging• Toolkit for 2017 National Nurses Week (May
6–12)• Thematic articles throughout the year in ANA’s
periodical, American Nurse Today• MultipleNavigateNursingwebinarsrelatedtothe
Year of the Healthy Nurse
Visit www.nursingworld.org/2017-Year-of-Healthy-Nurse today for more information!
Reference:Insight Consulting Group (ICG) & American Nurses
Association (ANA), (2016). Health risk appraisal exploratory data analysis: November 30, 2016. (PowerPoint slides).
2017: YEAR OF THE HEALTHY NURSEBalance your life for a healthier you.
Opioid Medication Assisted (MAT) Treatment Education“Recipe Book for Integrated Care,” Seminar by Jeff Watts, M.D.
Juliana L’Heureux, BS, MHSA, RN
Many nurses, count myself among them, are finding it challenging to learn as much as possible about the responses to the opioid epidemic. Most of us know families and have cared for patients who are disabled by the addictive use of opioids. Sadly, the epidemic is killing young people. In fact, timely on-line resources are available to help us learn more.
On-line, I’ve taken several free educational programs(unless specific continuing education credits were required by the attendees at a small cost). I learned about opioid addiction rehabilitation treatment modalities and the recommended dosages of morphine equivalents in a series of on line seminars sponsored by Maine Quality Counts.
In May, another excellent seminar was made available by the Addiction Technology Transfer Center (ATTC), in Great Lakes, Illinois, titled, “Recipe Book for Medication Assisted Treatment (MAT) Integration,” (slides from this education program are posted here or manual entry: http://www.attcnetwork.org/userfiles/file/GreatLakes/Webinars/2017%20Webinars/Watts%20Webinar%20Final.pdf).
Jeff Watts, M.D., a psychiatrist and addiction medicine physicianwithCookCountyHealth&HospitalsSystem,inChicago, was the expert presenter for the recipe seminar. As a matter of fact, at one time, I lived and worked in nearby Lake County, Illinois, for several years, I was confident that Dr. Watts would bring a vast amount of experience with the epidemic to his presentation on this particular subject.
A useful aspect of the “recipe” seminar was focused on how the clinical information integrated into the primary care setting. Therefore, the instructions were based on the most current evidence based treatments for consideration in an integrated patient care plan.
At the outset, it was helpful to review the current definitions of “addiction” and, especially, to understand how the disease must not stereotype the patient. In fact, addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry that leads to characteristic biological, psychological, social and spiritual manifestation. Moreover, addiction is also a mental, physical, and spiritual disease, as defined in the Big Book of Alcoholics Anonymous. In yet another definition, addiction is a chronic, relapsing brain disease that is characterized by compulsive drug seeking and use, despite harmful consequences. Regardless of how many definitions apply tothedisease,it’simportanttoknowthatanaddictisnota bad person trying to get good, but is a sick person trying to get well.
Medication Assisted Treatment (MAT) for addictive disorders or substance use disorders (SUDs) currently refers to FDA-approved treatments for nicotine, alcohol, andopioid/heroin use disorders. There are also medicationsthat have been “off-label” due to known effects on SUDS. Additionally, many clinical trials are examining novel medications, drugs and vaccines for possible MAT use.
Three key ingredients are necessary for the MAT recipe: (1) identify the need in the integrated care setting to treat opioid addicted patients, (2) provide training for prescribers who treat the patients with the addiction disorders, and (3) hire a MAT Coordinator who can be a social worker,
or nurse who has the primary job of communicating between patients and prescribers. Details about the three ingredients described for the integrated care recipe are described in bullets listed on the program’s presentationslides.
Common patient management issues addressed in the recipe for integrated care and Medication Assisted Treatment, described by Watts, focused on opioid dependence and co-morbid psychiatry issues; opioid dependence and other substance use disorders like alcohol, cocaine, benzodiazepine and other drugs; chronic pain, and acute pain related to surgeries or trauma. Indeed, Watts presented well organized information about complex topics, well worth referencing in the program slides.
Watts described the opioid epidemic as being “enormous in scope.” In response, many grant funded projects, clinical trials, treatment and recovery programs, task forces, clinical passion and political fervor are coordinating to reach those who want to know more about how to address this problem. As a result of the “hysteria,” a complex response is growing to support a network for Medication Assisted Treatment. The effectiveness of this methodology or recipe, includes extensive support, education, training and mentoring for the medical staff, care givers and patients. “As we tell our patients,”saidWatts,“don’tbeafraidtoaskforhelp!!”
More information about how to access the Maine Quality Counts presentations are posted on the website www.mainequalitycounts.org.
Acces s to the webs i te fo r the Addic t ion Technology Transfer Center in Illinois is available at www.ATTCnetwork.org.
August, September, October 2017 ANA Maine Journal Page 11
MeMbershiPThe Alliance of Nurses for Healthy Environments
Sally Melcher-McKeagney, RN
The Alliance of Nurses for Healthy Environments (ANHE) has been in existence since 2008. The Mission of ANHE is “Promoting healthy people and healthy environments by educating and leading the nursing profession, advancing research, incorporating evidence-basedpractice,and influencingpolicy.”ExecutiveDirectorKatieHuffling isanurse, and the seven members of the Board of Directors are all nurses. The ANHE has four Workgroups that address each piece of the Mission Statement. The Workgroups do much of their work through monthly or bi-monthly telephone calls, and all nurses are encouraged to participate.
In June of 2017, the ANHE issued a statement on the U.S. withdrawal from the Paris Agreement, which deals with greenhouse gas mitigation, and adaptation for countries most affected by climate change. http://envirn.org/statement-on-trump-administration-withdrawal-from-the-paris-climate-agreement/. ANHE also issued a statement on the EPA’s rescinding of the Obama’s Administration CleanWaters Rule, http://envirn.org/anhe-statement-on-epa-plan-to-rescind-the-clean-waters-rule/.
Also in June, ANHE put on a two day workshop at Georgetown University entitled “Climate Change, Health and Nursing: A Call to Action.” Speakers included Gina McCarthy, the former Administrator of the U.S. Environmental Protection Agency (EPA). See what good things she had to say about nurses here: http://envirn.org/anhe-climate-and-health-conference-a-success/. Attending ANHE conferences is very helpful for nurses who want to learn how to talk not just with patients and members of their communities, but also with their legislators, including members of Congress. Nurses are the largest health care discipline in the United States, and their voices are vital both in their communities and in Washington, D.C.
Nurses have found that the most effective way to educate patients and others about climate change is by focusing on the effects that climate change has on human health and public health, rather than focusing on the environment itself. Talking about the increasing prevalence and severity of asthma, for example, brings the effects of climate change home for parents of children with asthma. Teaching and speaking about the effects of climate change on human health also comes naturally to nurses, who always have stories about patients, community members, and family and friends whose health has been affected by climate change. Writing letters to the editor of the local paper is an effective way for nurses to make their voices heard. Mentioning your Senator and Congress members in the letter means their staff members will take notice of your letter, too.
I have been to Washington D.C. twice now with support from ANHE. Last year I traveled to Portland, Maine, for a conference on climate change at the University of New England. In D.C. and in Portland, I met other nurses from all over the country. Hearing their stories was uplifting and empowering. Those trips completely changed how I felt about advocacy and about speaking to legislative staff, patients, and members of my community about my concerns for the environment. I learned that I really was capable of speaking and of being heard in Washington, D.C., and that nurses are really listened to and respected.
ANHEisactiveonsocialmedia.IfyouareonFacebook,makesureto“like”Allianceof Nurses for Healthy Environments. The website (http://envirn.org) includes ways to keep informed about environmental health via blogs and newsletters, as well as upcoming conferences and opportunities to visit your Senators and Representatives with support from ANHE. If you have questions about ANHE, or would like to know more abouthowyoucanhelp,contactKatieHuffling,[email protected] or Cara Cook, Climate Change Program Coordinator at [email protected].
WHO CAN REGISTER TO VOLUNTEER?We all have a role to play in preparing Maine for the challenges of responding to a public health or healthcare emergency. MAINE RESPONDS seeks volunteers from all backgrounds, skill levels, and experiences willing to support a public health or healthcare emergency response. If you work in a health-related discipline, we encourage you to register with MAINE RESPONDS.
MAINE RESPONDS Emergency Health Volunteer SystemJared McCannell, Volunteer Management Coordinator Phone: 207-287-4072 | [email protected]
WWW.MAINERESPONDS.ORG
The MAINE RESPONDS Emergency Health Volunteer System provides a prepared and ready workforce of volunteers to
serve the people of Maine in the event of any public health emergency.
