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President's Message . . . . . . . . . . . . . . . 3AzNA PAC . . . . . . . . . . . . . . . . . . . . . . 3Executive Director’s Report . . . . . . . . . . . 4Your Place in the History of Nursing . . . . 6The Arizona Foundation for the Future of Nursing: Annual Update . . . . . . . . 7AzNA/AzNF Calendar of Events . . . . . . 7The Role of the Nurse Navigator . . . . . . . 8The Expert Witness as a Defense Tool . . . 9
Political Activism: Preparing Future Nurses to Impact Healthcare Policy . . 10Members on the Move . . . . . . . . . . . . . 12Intermittent Fasting . . . . . . . . . . . . . . . . 13Welcome New and Returning Members . 14Renewing your Nursing License: Changes you need to know about . . . 14AzNA’s Superstars . . . . . . . . . . . . . . . 15Two Year Anniversary Members . . . . . . 15
Quarterly Publication direct mailed to over 89,000 Registered Nurses in ArizonaVol. 73 • Number 1JANUARY 2020
One Profession. Many Roles.
Arizona NurseWe’re Working for You! JOIN US TODAY
Brought to you by the Members of AzNA . For more information on the benefits of membership, please visit www .aznurse .org .
The Official Publication of the Arizona Foundation for the Future of Nursing
Do you have a nurse pride license plate you want to share? Send it to [email protected]. You might be on our next front page!
I was named RaRa by my oldest grandson and wanted to declare it for all to see!
- Mary W.
Hi here is my RN license plate, I graduated from the University of Arizona with a BSN.
I’ve been an OR nurse for 30 years. - Marsha K.
I was so excited to get my first ANA newsletter in the mail! I saw the cover feature for the plate and I had to share my personalized vanity plate
with you. I know there’s thousands of BSNs and RNs out there but I’m proud to now be
numbered among them! - Shannon T.
Arizona’s state school nursing programs create proud nurses with unique stories.
NURSE PRIDE
Beginning with our April 2020 issue, Arizona Nurse will be distributed as part of Arizona Nurses Association membership services and will be available as an electronic publication to non-members.
Several years ago, Arizona Foundation for the Future of Nursing and Arizona Nurses Association adopted an environmentally friendly approach to our events and meetings. We use online communications for events and programs instead of paper, we have reduced the amount of paper the Association and Foundation use at events and meetings, and we encourage ride-sharing as a more efficient means of transportation to our events.
With this in mind, the Arizona Foundation for the Future of Nursing will be transitioning the distribution of our quarterly newsletter starting with our April issue of Arizona Nurse.
Whether you want to go green or just like reading on your tablet, signing up for the online version of Arizona Nurse is easy! Instead of receiving a printed copy, you’ll get a copy in your email inbox (and you will get it faster, too). Register your email and sign up to receive Arizona Nurse electronically.
Sign up for electronic version of Arizona Nurse - https://tinyurl.com/AZNurse
If you have any questions or comments about Arizona Nurse, please email them to [email protected]
ARIZONANURSE
is GOING GREEN!!!Members of AzNA will continue to receive a printed copy of the
publication in addition to an emailed copy.SUBSCRIBE TODAY at HTTPS://TINYURL.COM/AZNURSE
Page 2 • Arizona Nurse January, February, March 2020
Chair: Rhonda Anderson, DNSc, RN, FAAN, FACHE
Vice Chair: Pat Mews, MHA, RN, CNOR
Treasurer: Melissa Huckins
Secretary: Chloe Littzen, BSN, RN
Scholarship Chair: Sharon Rayman, MS, RN, CCTC, CPTC
Elected Trustee: Carol Stevens, PhD, RN
Elected Trustee: Kimberly Behrens-Grieser
Elected Trustee: Jeff Cox
Elected Trustee: Phillip Guarrera
Executive Director: Robin Schaeffer, MSN, RN, CAE
Board of DirectorsPresident:
Selina Bliss, PhD, RN, CNE, RN-BCVice President:
Heidi Sanborn, DNP, RN, CNESecretary:
Amanda Foster, BSN, RNTreasurer:
Beth Hale, PhD, RNGovernment Affairs Officer:
Denice Gibson, DNP, RN, CRNI, BMTCN, AOCNSDirector-At-Large:
Janice Bovee, MSN, CNMDirector-At-Large:
Jason Bradley, PhD(c), MSEd, RN, CCRN-K, LPCPast President:
Carol J. Stevens, PhD, RNStaff
Robin Schaeffer, MSN, RN, CAE, Executive Director
Debby Wood, Office ManagerWendy Knefelkamp, Communications Manager
Debbie Blanchard, Administrative Assistant
The Arizona Nurse (ISSN 0004-1599) is the official publication of the Arizona Foundation for the Future of Nursing (AzFFN), peer reviewed and indexed in Cumulative Index for Nursing and Allied Health Literature. Arizona Nurse Author Guidelines are available at www.aznurse.org. Call 480.831.0404 or [email protected] for more information.
No material in the newsletter may be reproduced without written permission from the Executive Director. Subscription price: included in AzNA membership or $30 per year. The purpose of the Arizona Nurse is to communicate with AzNA members and non-members in order to 1) advance and promote professional nursing in Arizona, 2) disseminate information and encourage input and feedback on relevant nursing issues, 3) stimulate interest and participation in AzNA and 4) share information about AzNA activities.
For advertising rates and information, please contact Arthur L. Davis Publishing Agency, Inc., 517 Washington Street, PO Box 216, Cedar Falls, Iowa 50613, (800) 626-4081, [email protected]. Responsibility for errors in advertising is limited to corrections in the next issue or refund of price of advertisement.
Advertisements do not imply endorsement nor approval by the Arizona Foundation for the Future of Nursing (AzFFN) of the product advertised, the advertisers or the claims made. AzFFN shall not be held liable for any consequences resulting from the purchase or use of advertised projects. AzFFN, AzNA and Arthur L. Davis Publishing Agency, Inc. reserve the right to reject advertisements. Rejection of an advertisement does not imply that the offering or product for advertisement is without merit, lacks integrity, or that this association disapproves of the offering or product.
The Arizona Nurses Association is a constituent member of the American Nurses Association.
Arizona Nurse Editorial Board
Alicia Shields, MSN, RN, CENP (Chair)Kimberly A. Callahan, MS, APRN, FNP-C
Anna Hustin, MSN, RN, NE-BCMelisa Salmon, RN, MSN, MBA, CCRN
Sherry Ray, Ed.D., MSN, RN | Melissa Zuber, BSN, RN
The editorial board of the Arizona nurses is comprised of members of the Arizona Nurses Association, who review all submissions, provide expert advice on content, attract new authors, and encourage submissions.
If you are interested in serving on the editorial board, please contact [email protected] for more information.
The caption for this picture, printed in the October 2019 edition of Arizona Nurse, incorrectly identified Mary Harden, second from right, as Heather Healy. The corrected caption is below.
Success Pays – So Why Not Jump Aboard?What if you could become a certified nurse or
recertify while lowering your test-taking anxiety and out of pocket cost? AzNA has partnered with ANCC for the new Success Pays Program. AzNA members can apply to take the exam up to two times and pay only if they pass the exam. Certifications with ANCC can also be renewed through AzNA at a reduced price.
To kick off this new program, the Arizona Foundation for the Future of Nursing is offering scholarships through the Sasmor Scholarship Fund.
Beginning in 2020, the first ten AzNA members per year who successfully pass their certification exams will have their ANCC fees paid in full.
Read more about the Success Pays Program and available scholarships for certification at aznurse.org/SuccessPays.
If you’re not a member, now is a great time to join to take advantage of all of the member benefits AzNA and ANA have to offer you. Membership is just $15 a month. Visit aznurse.org/Join for more information.
Benefits of Certification, Yes, Again!Christen S. Stevens, RN
I’ve read many articles on certification. Each
speaks to the same giant list of reasons one should get a certification, and yet some of you are not sold on it. I am here to add a new twist on this topic from the viewpoint of a nurse educator who is certified three times over.
It’s not about the money.Some health systems will give nurses a one-
time bonus for obtaining their certification, while others use certification to help nurses climb a Clinical Ladder, which may result in a pay raise. Some health systems may give the nurse an hourly pay raise for their certification, while others may reimburse the nurse for their test when they have achieved a passing score.
But let’s be honest, the time and effort you must put into getting your certification, and maintaining it, won’t be covered by the cash. How could it? It’s hard to put a price tag on the stress that comes with getting the certification and keeping it.
It’s not about the recognition.After getting your certification, some
health systems will make an announcement in their newsletter announcing the nurse’s new certification, while others will distribute badge tags or certification pins. Every year, Certification Day comes around where certified nurses are recognized with free meals, lunch boxes, water bottles, backpacks, and cookies galore!
The recognition is helpful and appreciated, but it isn’t why we get the certification.
It’s about you!Getting the nerve up to take a certification test
is difficult. Fear of failure is one of the hardest
things to overcome. I have struggled with it despite having multiple certifications! The “what if” mind game will bring you to your knees. Just like nursing school, this too shall pass!
The only way to know if you can pass the test is to take it. I am triple certified and proud of it! I did it for me. Being certified will improve my patient’s outcomes. I am a nurse to make people feel and do better, and what I learned while studying for and maintaining those certifications help that cause. I am committed to my art form- Critical Care Nursing.
The pride that comes with a certification IS worth it! It is worth all the pain and anxiety the test brings. It is also worth the attention required to maintain that certification (so you don’t have to take that wicked test ever again!)
So, what’s the hold-up?Pick a certification you want and are eligible to
take (Don’t try to scam the national certification board, it’s so not worth it!)
Decide on a study method: Prep class, self-study program, webinar (ANA offers many, with discounts to members), prayer, or osmosis.
Set a date: this is a must! If you don’t set a date because you aren’t ready, you will never take the test. Notice how nursing school didn’t give you an option when to take your final test? That’s because they know you will never feel ready.
So go, be great for yourself! It’s worth it! You will see!
*Don’t miss out on great member discounts and benefits for ANCC certification. Visit aznurse.org/successpays for more information!
Christen S. Stevens, MSN, ACCNS-AG, APRN, CCRN, TCRN
Correction
Susanne Buchannan (left) spoke about the impact nurses have on their patients during her presentation ‘Burn Nursing: Turning Devastation into Determination.’ Included in her presentation, Isabella McCune, age 10 (center), former patient at the Arizona Burn Center, spoke about how her time in the burn unit inspired her to become a nurse. The Arizona Foundation for the Future of Nursing awarded Isabella a nursing scholarship to pursue her education.
Also pictured, Lilly McCune, Mary Harden, and Robin Schaeffer.
January, February, March 2020 Arizona Nurse • Page 3
PRESIDENT’S MESSAGE
2020 – The Year of the NurseWhat an exciting time
this is as we enter into the year 2020 and prepare to celebrate the Year of the Nurse! The World Health Organization has declared 2020 the International Year of the Nurse and Midwife as nurses are recognized for their vital role in transforming healthcare around the world. To further showcase the over four million Registered nurses in the United States, the American Nurses Association (ANA) has announced the year 2020 as the “Year of the Nurse.”
Mark your calendars for May 6th to May 12th as we get ready to celebrate National Nurses Week. Even better, in order to elevate and celebrate nursing, this year the ANA plans to celebrate the Year of the Nurse over the entire month of May. Each week in May will have a different theme starting the first week with Self Care, then the second week with Recognition, followed by the third week with Professional Development, and the final week of the month the focus on Community Engagement. To prepare for the festivities, on the ANA website you can download the official Year of the Nurse toolkits and logos. Nurses can follow along with the month-long celebration using various forms of social media, including #yearofthenurse on Twitter and #YON2020 on Facebook. Our opportunity to celebrate our accomplishments will be here before we know it!
While still considered the most trusted profession, as we advocate for patients across
the continuum and lifespan, we still have our challenges ahead of us. As we move ahead, both locally and nationally, we have more work to do on safe staffing, incivility, nurse abuse, self-care, workforce, and patient safety. What is your part in advancing the nursing profession and promoting a healthy Arizona?
Fortunately, ANA gives us plenty of tools to empower ourselves and our profession. We have more influence than we realize, we just need to harness our energy. Programs such as the Nurses on Boards Coalition and the End Nurse Abuse Campaign are just a few examples of how ANA has recently worked to transform healthcare through nursing leadership. When it comes to advancing yourself professionally, I hope you are taking advantage of our Success Pays Program at AzNA where you can get certified through the American Nurses Credentialing Center (ANCC). Certification in your specialty area has been made easier and hassle-free when you are a member of AzNA, as you can take the exam up to two times and pay only if you pass! To top it off, the Sasmor Scholarship Fund has agreed to fully fund the first ten AzNA members who are initial test takers and successfully pass their exam in 2020. As you can see, this is a great year to achieve or renew your certification!
Locally, we are looking forward to RN Advocacy Day on January 31st which is a virtual event that will include an overview of how to prepare nurses to use their voice to influence public policy at our Arizona State Capitol. Following this, we have RN Day at the Arizona Capitol on February 5th. Join me as we make ‘rounds’ and visit our legislators both
in the Senate and the House. Take in as much, or as little, as your schedule allows. Visit aznurse.org/events for more information.
The beginning of a new year is a time to ponder what drives, motivates, and sustains us to be a nurse. While we pause to reflect and look forward to a new year, I am reminded we have many milestones to celebrate. While AzNA turned 100 years old in 2019, Florence Nightengale is also turning 200 this year as we celebrate the 200th anniversary of her birthday. I have the feeling this is going to be a great year for nurses!
Looking forward to the next 100 years for AzNA and an exciting 2020 for the Year of the Nurse!
Selina Bliss, Ph.D., RN, CNE, RN-BC, ANEF
Selina Bliss, RN
THE AzNA PAC – Preparing for a Robust 2020 Election Year!
You should know, understand, and become involved in the AzNA PAC (Political Action Committee). Endorsing legislators that support AzNA’s Public Policy Agenda and AZ nurses is critical. AzNA’s Centennial celebration, Sept 19-20, 2019, was an important milestone for nurses in Arizona. Among many accomplishments AzNA has had over the last 100 years, the association’s success as a policy advocate is indisputable. From lobbying for a Nurse Practice Act to Full Scope of Practice for APRNs, AzNA has become a leader in using nursing’s voice at the legislature to make an impact. We could not do this without working with our legislators and having the right legislators in office.
The purpose of the AzNA PAC is to endorse candidates for the AZ Legislature based upon the principles of the AzNA Public Policy Agenda. The PAC evaluates, endorses, and contributes to candidates for the Arizona Legislature who have clearly demonstrated responsible awareness of nurse’s needs. AzNA-PAC encourages nurses to become active and effective in shaping public policy through the electoral process.
The AzNA PAC is similar to the ANA PAC. ANA’s PAC helps ANA maintain a political presence in
Washington, DC by identifying and promoting the election of pro-nursing candidates. They focus on the successful coordination and implementation of three critical components at the Federal legislative level: lobbying, grassroots advocacy, and political advocacy. AzNA’s PAC is the political action arm of AzNA; an unincorporated, not-for-profit, politically non-partisan committee that operates within the policies, bylaws, and positions of ANA/AzNA.
The AzNA-PAC leadership team is comprised of Chair, Secretary, Treasurer, and four committees:
• Endorsement Committee – responsible for the candidate endorsement process, working closely with the AzNA lobbyist and Executive Director. Participates in reviewing questionnaires and interviewing candidates for primary and general elections.
• Campaign Strategies Committee – responsible for supporting endorsed candidates. Strategizes, plans, and mobilizes capacity to support candidates throughout the state. Works closely with AzNA Chapters and affiliates to support campaign strategies, such as canvassing, yard signs, call banks, social media, etc.
• Communication/Education Committee – responsible for communication, education, and raising awareness of candidate endorsements, voting, and the political process. Creates content to educate nurses such as articles for Arizona Nurse, social
AzNA PAC
media messages, and ‘PAC columns’ for AzNA Chapters and affiliates. Organizes PAC presence at events that provide opportunities for PAC, such as Nursing Associations, Students, and Nursing Conferences in AZ.
• Fundraising Committee – responsible for leading fundraising efforts for the PAC. Creates and utilizes donor database, helps to plan fundraising campaigns and events, and organizes PAC presence at conferences (i.e. NP Symposium, Nurse Educator, Advocacy Day, etc.) to enlist new and returning donors.
AzNA PAC committees are forming and
planning for a robust 2020 election year! If you have a particular passion for any of the committees’ activities described above, we want to hear from you.
We know that in order to make changes, to be heard and to use our voice, nurses must be involved in the political process. It is not an option to let others (non-healthcare leaders) make decisions affecting our patients and our practice.
If you are interested in starting out your new year by getting involved in the AzNA PAC, please contact Colleen Hallberg, MSN, RN, Chair of AzNA-PAC at [email protected] or by visiting aznurse.org/Volunteer.
Page 4 • Arizona Nurse January, February, March 2020
EXECUTIVE DIRECTOR’S REPORTEverything is Different and Nothing has Changed
As we celebrate 100 years as the most recognized nursing association in Arizona, is it possible that our everyday business looks very similar to 1919? You bet it is!
Of course, what is different are the faces of our members, fashion styles and trends, technology and more. However, when delving into our archives I was surprised to find that our business focus and practice issues have been the same for 100 years. As a non-profit volunteer member association, we have always been focused on advancing the profession of nursing. Through the work of our founding members and hundreds of dedicated Arizona nurse volunteers our focus has been and continues to be nursing workplace, nursing workforce, nursing education and nursing scope of practice. Here are some priceless snippets of history.
In 1919, our founding year, the goal was to raise the standards of nursing and secure state registration of qualified nurses in Arizona. Three separate Graduate Nurses Associations (Maricopa County, Pima County, Cochise County) convened and founded the Arizona State Nurses Association. 42 graduate nurses signed the 1st Register of Attendance on December 3rd, 1919 and the rest was history!
The 5th person to sign the register was Sister M. Evangelista, who is also famous as the first nurse to receive a license after AZNA worked hard to create the Arizona Board of Nursing Examiners and
the first Nurse Practice Act.
Whether it’s 1952 or 2018, AzNA has always kept in step with fashion when representing Arizona during national meetings of the American Nurses Association (ANA). We are a respected voice
during national conversations. Many of our AzNA nurses have led and still lead national level work at the American Nurses Association.
An Arizona Nurse was ANA President!Rosamund Gabrielson started her volunteer journey at the chapter level as president of District 1, now the Greater Phoenix Chapter 1. She then served as AzNA president from 1965 to 1969 and in 1972 was elected President of the American Nurses Association, the second nurse west of the Mississippi to be elected to that position!
Robin Schaeffer, RN
AzNA Board of Directors Meeting Highlights - December 2019
The AzNA Board of Directors meets monthly. The following are highlights from the December 2019 meeting held on the 11th.
• In conjunction with the Arizona Foundation for the Future of Nursing and with a grant from the Foundation of the National Student Nurses Association, progress is being made on the Future of Nursing grant. Phase I of the grant was to conduct virtual focus groups. 100 AZ
nurses participated. Groups were separated into: Direct Care Nurses (Early Career, 5 years’ experience or less), Direct Care Nurses (Mid to Late Career, over 5 years’ experience) Administrators, and Educators. Phase 2, a Day of Dialogue was held on January 16th.
• A look towards anticipated legislative issues for the 2020 legislative session includes nurse assault, vaccines, surgical smoke, and possibly recreational marijuana.
• Board review of proposed standardized AzNA chapter bylaws
• Debrief on preview of AzNA’s new online Nursing Professional Development and live webinar service
• Jason Bradley, RN, AzNA Director at Large, member of AzNA Rio Colorado Yuma Chapter 7, was appointed to serve as AzNA volunteer for an ANA committee on nurse suicide.
For a complete copy of the approved minutes, please contact [email protected] or call 480-831-0404.
Announcing Career OpportunitiesYou’ve Been Waiting For!
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• Saguaro Correctional Center - RN & LPNEloy, AZ
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Contact: Sherry Cameron at 615-218-1112
New Licensed Graduates Welcome!Competitive Salary and Pay Based on Experience.
Apply online at jobs.corecivic.com
CoreCivic is a Drug Free Workplace & EOE - M/F/Vets/Disabled.
Join a fun camp community and spend a summer in the
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Colvig Silver Camps has an open Nurse position for the summer of 2020. Overall responsibility for staff and camper
health, RN licensure required and pediatric experience preferred. Salary commensurate with experience and private
cabin/bathroom included. You have kids? We also offer a tuition benefit. July 11–August 11.
Contact Tyler Dixon 970-247-2564Visit: colvigsilvercamps.com
January, February, March 2020 Arizona Nurse • Page 5
In 2019, Carla Clark (pictured on left with ED Robin Schaeffer) and Shawn Harrell (pictured on right with ED Robin Schaeffer) joined the ranks of our life members.
Communication, Communication, Communication!
Since 1977 we have recognized AzNA nurses with a “life member” designation for their exemplary
contributions as a member of AzNA.
For over 70 years The Arizona Nurse, our quarterly print publication has kept Arizona nurses up to date on trends and issues in our state. 21st century communication now includes AzNA Today, a
weekly electronic newsletter, as well as a presence on Facebook, Twitter and Instagram.
White Caps in the Desert captures the history of AzNA between 1919 and 1969 and a 100-year timeline presented at the AzNA Centennial Convention. (The full timeline will be available in book
form just in time to celebrate 2020 Nurses Week)
Preserving our history is a task we take seriously. The AzNA office houses important documents and pictures. Here are two examples of how we have archived our history.
Thank you to our dedicated Archives Committee who met monthly to assure that we were ready for our Centennial celebration. Left to right, Barbara K. Miller, Pat Knutesen, Jean Stengel, Geraldine Greaves, Donna Adams, LoAnn Bell. Not pictured: Jeannine Dahl.
Florence Nightingale continues to have a presence in nursing history. AzNA would personally like to thank Florence for her support of our Centennial. We turned 100 and Florence will turn 200 in 2020! Her legacy lives on! How appropriate that 2020 has been designated the Year of the Nurse by the World Health Organization and the American Nurses Association. Take a look at AzNA president Selina Bliss’ article (page 3) for an update on how we will be celebrating.
Call for Article SubmissionSubmit your article or research for publication in AzNA’s quarterly print publication.
The Arizona Nurse is mailed to all 89,000+ RNs in the state.
AzNA welcomes submission of nursing and health related news items and original articles. We encourage short summaries and brief abstracts for research or scholarly contributions with an emphasis on application.
To promote inclusion of submitted articles, please review the article guidelines available on the AzNA website at www.aznurse.org/Guidelines.
An “article for reprint” may be considered if accompanied by written permission from the author and/or publisher as needed. Authors do not need to be AzNA members.
Submission of articles constitutes agreement to allow changes made by editorial staff and publishers. See article guidelines for more information.
Submit your article to [email protected].
To access electronic copies of the Arizona Nurse, please visit
http://www.nursingald.com/publications
Page 6 • Arizona Nurse January, February, March 2020
Your Place in the History of NursingShannon E. Perry, RN
If you have been a nurse for even five years, you have experienced changes in medicine and nursing care. Just think of the marvelous advances that have occurred during your career.
I graduated from my basic nursing program, a hospital diploma program, 60 years ago. We learned how to make turpentine stupes (have you ever heard of those?); we sharpened needles and washed and boiled rectal tubes (yuck!) for reuse. Only in the last six months of training could we start IVs of D5W. I remember log-rolling patients with fractured hips who were on bed rest for weeks;
today, after a hip pinning, the patient is ambulatory that evening. Women stayed in the hospital for five or more days after giving birth; today, mom and baby may be discharged a few hours after birth.
I am sure you have seen similar changes. Surgical techniques for problems have changed; treatment of patients with various types of carcinoma has advanced; HIV-AIDS care is no longer solely palliative. The organization and structure of nursing departments have changed. School nursing and public health nursing has evolved. Evidence-based practice is essential.
The Arizona Nurses Association just celebrated its 100th anniversary. The World Health Organization is honoring nurses and midwives during the 2020 Year of the Nurse, spanning the 200th birthday of one of history’s most well-known nurses, Florence Nightingale. Have you thought about your contributions to nursing history? The older I become, the more my interest in history grows. I have learned a lot about the evolution of nursing and health care through visiting museums of nursing and medicine and my membership in the American Association for the History of Nursing (www.aahn.org).
I have previously studied the care of children with polio in the early 1940s (Perry, 2015) and helicopter transport of premature infants (Perry, 2017).
Of particular interest was an oral history of a prominent nurse who, as a teenager, was an internee in a Japanese relocation center in Arizona (Perry, 2018).
While attending a reception at the Musical Instrument Museum in Phoenix, I saw a woman that I recognized; she had taught the Advanced Research Course I took during my master’s program at the University of Colorado in 1971. Not surprisingly, she did not remember me. She is Japanese-American, and that evening I learned that
she had been in a relocation camp as a teenager during World War II. She subsequently finished high school and went on to higher education and graduated with a BSN, MSN, and an MS and a Ph.D. in Sociology. During a long career, she was a distinguished nurse-educator, researcher, administrator, and Fellow of the American Academy of Nursing. With her permission, I interviewed her, reviewed her CV, read about Japanese Relocation camps, and took her to visit the Gila River War Relocation Center where she had been interned.
You, no doubt, know of other nurses who have a tale to tell by their example. Some names of Arizona nurses that come to mind include Loretta Bardewyck, Ellamae Branstetter, Mary Segall, Nancy Melvin, Hazel Bennett, Bea Steffl, Dorothy Corona, Janelle Krueger, Frances Mast, and Sister Alice Montgomery. Where are you in the history of nursing? What changes have you seen or initiated? Bystanders, participants, innovators, and authors all have their stories. Please tell us your story. Your peers, AzNA, and various journals and AAHN would love to hear from you.
Shannon E. Perry, RN, PhD, FAAN, AzNA Member, is Professor Emerita, San Francisco State University School of Nursing and now resides in Phoenix.
ReferencesPerry, S. E. (2015). A brief history of one boy’s experience
with polio. Poster presentation at the 32nd Annual AAHN Nursing & Healthcare History Conference, Dublin, Ireland, September 19, 2015.
Perry, S. E. (2017). A historical perspective on neonatal transport. JOGNN, 46(4), 647-656).
Perry, S. E. (2018). Betty Mitsunaga, RN, PhD, FAAN – An oral history of a resident of a Japanese intern camp. Podium presentation at the 35th Annual AAHN Nursing & Healthcare History Conference, San Diego, CA, September 14, 2018.
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January, February, March 2020 Arizona Nurse • Page 7
Friday, January 31, 2020RN Advocacy DayLocation: Virtual
Wednesday, February 5, 2020RN Day at the Arizona CapitolLocation: Arizona Capitol Buildings, Phoenix
Friday, April 24 - Sunday, April 26, 20206th Annual Renewal Retreat for NursesLocation: Franciscan Renewal Center, Scottsdale
Saturday, July 25 - Sunday, July 2632nd Annual Southwestern Regional Nurse Practitioner SymposiumLocation: Chandler
Registration and event information can be found at www.aznurse.org/events
AzNA/AzNF Calendar of Events
The Arizona Foundation for the Future of Nursing: Our Annual Update to You
The Arizona Foundation for the Future of Nursing (AzFFN), formerly known as the Arizona Nurses Foundation, is a nonprofit 501(c)(3) with the mission to “ensure Arizona has a sustainable nursing workforce to provide quality care for the health and wellness of our diverse and growing population.” As of October 2019, the AzFFN received just over $9500 in donations from personal gifts of past scholarship winners and AzNA members, the Honor a Nurse campaign, as well as exciting events at the Arizona Nurses Association (AzNA) Centennial Convention. At the AzFFN, we are grateful for every single donation we receive, as these funds provide needed support for our current and future Arizona nurses and the future of nursing.
Looking to the future, the AzFFN intends to continue to support Arizona nurses through three primary aims, 1) nursing scholarships, 2) the future of nursing initiative, and 3) leadership. For scholarships, Arizona nurses continue to be able to apply for financial support in their undergraduate and graduate nursing education.
Recently, the AzFFN has extended financial support to individuals seeking specialty certifications in the practice environment thanks to the Sasmor Scholarship Fund. With this partnership, 10 paid scholarships will be awarded to AzNA members who pass an American Nurses Credentialing Center (ANCC) certification test. Additionally, alongside AzNA, members can apply for financial support for professional nursing events such as the AzNA annual convention.
The future of nursing initiative, a newly secured grant from the Foundation of the National
Student Nurses’ Association, was developed to identify high-priority nursing workforce and practice issues in Arizona that we will face in the next 5-10 years. Subsequently, the identification of these high-priority issues will help develop innovative solutions to support future Arizona nurses and the health and wellness of Arizona residents.
Lastly, for leadership, the Arizona Nurses on Boards (AzNOB) task force has been working to improve the health of Arizona communities through the service of nurses on boards. In 2014, it was reported that
less than 1% of Arizona nurses served on health-related boards, but more than 3% were interested in serving on a board. The AzNOB task force provides resources to nurses who are interested in serving on boards through educational resources and mentorship.
We thank you for your support over the years, and we are honored to be a part of the community of Arizona nurses. Please consider donating to us in 2020, and join us in support of the future of nursing in Arizona. For more information on the AzFFN, or any of the items covered above, please explore our website at aznurse.org/Foundation.
Page 8 • Arizona Nurse January, February, March 2020
The Role of the Nurse NavigatorPaul Williamson, RN
While, arguably, the main reason students enter the profession is a desire to help people, one of the other many attractions for selecting nursing is the many career tracks offered by the nursing profession. While most nursing graduates will enter the nursing profession with a job taking care of patients in the hospital, there are additional options for nurses, including the role of nurse navigator.
During a single day, a navigator will provide many needed services for the patient. A navigator will triage patient calls, either telephonically or in the electronic medical record messaging system. He or she may provide a variety of clinical
procedures depending on specialty, wound care, spirometry, and others. Nurse navigators in the ambulatory care setting order tests, administer medications, verify completion of all testing, and see and provide education for patients during their clinic visit. Often nurse navigators obtain outside patient records, follow-up on patient referrals for completion, attend and lead quality improvement projects, order durable medical equipment, review patient charts, initiate and complete prior authorizations for treatments and medication, and collaborate with physicians and nurse practitioners.
The word navigator is a particularly concise term that describes a person who directs or plots a course or direction. While the position may
go by many titles, navigator encompasses the multiple functions a nurse in this role initiates and completes. The concept of navigator only stretches back to 1990, when an oncologist needed help for his underserved population of patients (Devine, 2017). Many of the poor and minority patients he served were not gaining appropriate access to care, timely treatment, and adequate follow-up. At that time, Dr. Harold P. Freeman enlisted the help of community laypeople to assist his patients through the myriad appointments, helping with travel, and everything that comes with cancer care (Devine, 2017). For his patients, utilizing navigators resulted in “… patients’ five-year survival rates [increased] from 39% to 70%” (Devine, 2017).
Quite a bit of the information about nurse navigation comes from oncology practice as these patients must be promptly and effectively guided through the various treatments and systems for their care. A group of researchers is evaluating some of the potential benefits of nurse navigation as an integrative care model in Queensland, Australia (Harvey, et al., 2019). They are focused on the study of nurse navigation for patients with long term conditions and life-long chronic diseases. Some of the aims of this two-year mixed-methods design are to reveal results related to:
1. Reduction in acute care services
2. Improvement in ambulatory visit adherence
3. Improved patient satisfaction
4. Sustainable models for nurse navigation
5. Cost-benefit analysis related to nurse navigation
As this nurse navigator role evolves, what
is evident is this is an effort at providing individualized patient care across the medical continuum. Some of the descriptors of this care include “interdisciplinary collaboration, care coordination, communication, information exchange, and shared governance” (Hannan-Jones, Young, Mitchell, & Mutch, 2019). Nurse navigators facilitate individualized patient care in direct collaboration with doctors, nurse practitioners, testing facilities (radiology, laboratory), referrals to and referrals from other care providers, along with other necessary care elements along the path.
The ultimate driving force is that patients will receive needed care in a timely fashion, avoiding hospital admission, and maximizing the quality of life. The patient benefits from a seamless provision of the best possible care.
Paul Williamson, PhD, MSN, ACNP, RN, RRT is an AzNA member in Tucson Chapter 2.
ReferencesDevine, A. (2017) the nurse navigator: a patient’s
compass on the healthcare journey. Nurse.org, April 3, 2017.
Hannan-Jones, C., Young, C., Mitchell, G., Mutch, A. (2019) exploring nurse navigator’s contributions to integrated care: a qualitative study. Australian Journal of Primary Health, 2019, 25, 339-345. https://doe.or/10.1071/PY19042
Harvey, C., Palmer, J., Hegney, D., et al (2019) the evaluation of nurse navigators in chronic and complex care. J Adv Nurs. 2019:75:1792-1804. https://doi.or/10.1111/jan.14041
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January, February, March 2020 Arizona Nurse • Page 9
The Expert Witness as a Defense ToolJennifer Flynn, CPHRM, Risk Manager,
Nurses Service Organization (NSO) Liability claims naturally create significant distress for nurses but acting
to defend themselves can help reduce that distress. Collaborating closely with the attorney is one such action step. During collaboration, the attorney may recommend an expert witness to testify on behalf of the clinician.
By understanding what expert witness testimony entails and the process for choosing an expert witness, nurses can understand how they can act in the nurse’s best interests.
Expert witnesses and “standard of care”An expert witness can help support a defendant’s claim. For example,
an expert can offer his or her opinion to support a clinician’s claim that the right decision was made in choosing a treatment plan, even though the patient suffered harm. However, expert witness testimony is complex, and understanding that complexity begins with understanding what the courts are considering.
The courts examine whether a clinician deviated from accepted norms of practice that resulted in patient injury (see Burden of proof). They consider “standard of care,” which is the care that a “prudent and reasonable” clinician would provide under similar circumstances. Interestingly, standard of care is a legal definition, not a medical one, which creates challenges in interpretation.
An expert witness can support that a clinician followed the standard of care. To be most effective in providing the support, the witness needs to offer testimony that is ethical and supported by evidence and standards.
Rules of the roadSeveral rules govern opinion testimony such as that provided by an
expert witness. These rules are found in Article VII of the Federal Rules of Evidence, a group of laws that governs admissibility of evidence in federal courts and state courts that use its rules.
Rule 701 refers to a “lay” witness offering opinion testimony. Lay witnesses must testify based on facts they have personally observed.
Rules 702 through 706 focus on expert witnesses. Rule 702 states that the following must be met for an expert witness’ opinion to be admissible:
• the expert’s scientific, technical, or specialized knowledge will help the judge or jury understand the evidence or determine a fact;
• the testimony is based on sufficient facts or data;
• the testimony is the product of reliable principles and methods; and
• the expert has reliably applied the principles and methods to the facts of the case.
The judge has the responsibility to assess the reliability of expert testimony, and various court cases have provided guidance in this area. For example, the decision for the 1993 case Daubert v Merrell Dow Pharmaceuticals Inc. suggested the following guidelines:
• whether the expert’s theory or technique can be (or has been) tested;
• whether the theory or technique has been subjected to peer review or publication;
• the known or potential error rate of the theory; and
• whether there is general acceptance in the relevant scientific community.
Rule 703 establishes the bases on which experts may form their opinions. A key point is that experts can base their opinions on inadmissible evidence if that evidence would help the jury’s understanding.
Rule 704 allows an expert to offer an opinion on the ultimate factual issue. Rules 705 and 706 also refer to expert testimony but are beyond the scope of this article. For more information, see www.theexpertinstitute.com/the-ultimate-guide-to-the-federal-rules-of-evidence-and-expert-witnesses.
Burden of proofThe burden of proof in a medical malpractice case is on the plaintiff. A
jury must accept that all elements of a malpractice action have been met by a “preponderance of evidence” (unlike a criminal case, which uses the higher standard of “beyond a reasonable doubt.”) The four elements are:
• There was existence of a legal duty of care.
• There was a breach of that duty.
• The breach caused the injury.
• There was measurable harm from the injury.
Path of expert witness testimonyNot all expert witnesses will testify in court. The attorney often first asks
the witness to review the case and provide a written opinion. Depending on the opinion, the witness would then be deposed. During a deposition, the expert witness answers questions from attorneys on both sides. If the case is not settled, the expert witness will likely testify in court.
Choosing an expert witnessAn attorney considers many factors when selecting an expert witness,
including not only expertise but other factors such as previous experience testifying. Credentials such as board certification can also play a key role in establishing the witness’ expertise.
Attorneys find expert witnesses through a variety of sources, including online directories. Attorneys look at the following criteria when screening the potential witness:
• criminal records
• previous testimony and its outcome
• professional licensure and board certifications
• board sanctions and malpractice claims
• professional and corporate affiliations
• publications and presentations
• conflicts (to ensure that the expert is not connected to the defendant in any way)
• subject matter expertise.
Expert inputNurses understand the importance of consulting and employing experts.
In the case of litigation, an expert witness may make the difference in successful defense against liability charges.
Jennifer Flynn, CPHRM, Risk Manager, Nurses Service Organization (NSO), Healthcare Division, Aon Affinity, Philadelphia. Phone: (215) 773-4513. Email: [email protected].
Resources1. Cappellino A. Federal rules of evidence and experts: the ultimate guide. The
Expert Institute. 2016. www.theexpertinstitute.com/the-ultimate-guide-to-the-federal-rules-of-evidence-and-expert-witnesses.
2. Cappellino A. The standard of care for medical malpractice: what you need to know. The Expert Institute. 2018. www.theexpertinstitute.com/standard-care-medical-malpractice-need-know.
3. Legal Information Institute. Rule 701. Opinion testimony by lay witnesses. www.law.cornell.edu/rules/fre/rule_701.
4. Legal Information Institute. Rule 702. Testimony by expert witnesses. www.law.cornell.edu/rules/fre/rule_702.
5. Narang SK, Paul SR, Committee on Medical Liability and Risk Management. Expert witness participation in civil and criminal proceedings. Pediatrics. 2017;139(3):e20164122.
6. Robinson K. Expert witness. StatPearls. 2019. www.statpearls.com/kb/viewarticle/21455. This risk management information was provided by Nurses Service
Organization (NSO), the nation’s largest provider of nurses’ professional liability insurance coverage for more than 550,000 nurses since 1976. Arizona Nurses Association (AzNA) endorses the individual professional liability insurance policy administered through NSO and underwritten by American Casualty Company of Reading, Pennsylvania, a CNA company. Reproduction without permission of the publisher is prohibited. For questions, send an email to [email protected], call (800) 247-1500, or visit www.nso.com.
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Page 10 • Arizona Nurse January, February, March 2020
Political Activism: Preparing Future Nurses to Impact Healthcare Policy
Lisa Jaurigue, RNCheryl Schmidt, RN
Nursing programs need to address the topic of political activism and healthcare policy to prepare future nurses to impact the health of our nation. In today’s rapidly changing world, nurses need to be equipped with knowledge and skills to address many healthcare issues. Political activism is a way for nurses to become active in creating, influencing, and advocating for healthcare policy that will impact the health of patients, families, and communities.
Nurse educators have long realized and strive for teaching strategies that include active learning. Ideas are needed that go beyond the passive lecture and allow students to move into an active phase of learning where the content is reflected upon and applied by nursing students. This, in turn, can provide future nurses who can make a difference in the community and world through political activism.
Spiraling is a concept that is prevalent in nursing education. Taking the theme of political activism and building on it, requiring our students to continue to broaden their knowledge, is essential. We looked at political activism content and made sure that we did not repeat but instead built on the previous experience in our students’ senior year.
Getting StartedIn threading political activism content, communication among faculty from
various courses was critical. Discussions on what was currently being taught and assessed regarding the topic occurred. Also included in these decisions was the experiences and expertise of faculty in regards to teaching community health content and working within professional nursing and public health organizations. This was valuable in terms of deciding what nurses needed to know to be politically active and impact healthcare policy.
From this communication, it was decided that the stages of political activism, proposed by Kelly (2007), would be taught and reflected on as a basis for moving our students forward within the political activism stages:
• Apathy – “The apathetic nurse doesn’t belong to professional organizations, takes little or no interest in legislative politics as they relate to nursing and health care, and may not be a registered voter” (Kelly, 2007).
• Buy-in – “The nurse starts to recognize the importance of activism within professional nursing organizations but hasn’t taken an active role in these organizations. He or she starts to become interested in legislative politics related to critical nursing issues but takes little or no political action. Nurses at this stage are likely to be registered voters” (Kelly, 2007)
• Self-interest – “The nurse seeks involvement in professional organizations to further his or her career and seeks to develop and use political expertise to promote professional self-interest” (Kelly, 2007)
• Political Sophistication – “The nurse is active at the professional organizational level and may hold an organizational office at the local or state level. He or she has moved beyond self-interest and recognizes the need for activism on behalf of the public” (Kelly, 2007).
• Leading the Way – “The nurse serves in an elected or appointed position at the state or national level of a professional organization. To provide true leadership on broad healthcare interests within legislative politics, he or she may seek appointment to policymaking bodies. Some nurse-leaders seek election to political office” (Kelly, 2007).
Political activism content was moved, refined, developed, and piloted to strengthen our nursing program and prepare nurses who can impact healthcare policy. In the first semester of the senior year, we provided a foundation for the students to learn about types of laws, the bill process, the role of a nurse, and political activism. From there, an investigation into current laws and bills, use of evidence, and components of letter writing were addressed. Below is the spiraling of the political activism content we decided upon for the senior year:
Term 7 (1st semester senior year) Term 8 (2nd semester senior year)Course – Population Health Course – Integration of Concepts in
HealthcareTheory content:• Different types of laws• How a bill becomes a law• Nurse’s role in the political
process• Stages of Political Activism (Kelly,
2007)
Theory content:• Current laws and bills• Health care laws and their impact
on health and nursing• Use of evidence to support
position• Letter writing formatting for
elected officials
From the didactic or theory content, assessments/assignments were developed that allowed for the application of content as well as measurement of the political activism outcomes for our courses and program. Provided is a list of the assessment/assignments and where they fit for spiraling during the senior year:
Term 7 (1st semester senior year) Term 8 (2nd semester senior year)Courses – Population Health Course – Integration of Concepts in
HealthcarePolitical assessments/assignments:• Reflection on stages of political
activism• Elected officials worksheet:
Identify state and federal elected officials
• Exam questions• State Capitol visit-Optional
Political assessments/assignments:• Discussion board and reply: Bill
of interest• Write and send a letter to an
elected official regarding a bill, legislative issue, or idea.
• State Capitol visit-Optional
One of the critical foundational assignments that was deemed necessary for political activism was a reflection on the stages of political activism. This allowed students to venture inside their person to identify where they stand in regards to being politically active for healthcare. This assignment was rather simple but meaningful. There were directions, the stages of political activism, and two questions to reflect on. A template was provided for the students to complete this assignment. See Appendix A
The second assignment within the first semester of the senior year is the Elected Official Worksheet. This assignment allows the students the opportunity to identify their elected officials and get to know them, their committees, and their interests. This worksheet was a necessary step for the next course’s content and assignments. A template was provided for the students to guide their work. See Appendix B.
Various exam questions are also included within the assessment process that measures knowledge attainment regarding how a bill becomes a law, the nurse’s role in the political arena, stages of political activism, and types of law. The type of questions employed are aimed at application and above on Bloom’s Taxonomy.
The last semester in the senior year builds upon the previous semester. Students participate in a discussion board by posting and replying to a peer’s post regarding past or current bills of interest and their thoughts and opinions regarding such bills. This allows them to investigate resources with bill information such as the Arizona State Legislature website or the Arizona Nurses Association website. Interacting with peers allows for a broadening of perspectives by learning others’ thoughts and opinions.
Students also have the opportunity to apply political influence by writing a letter to an elected official. Armed with all their previous political activism content, letter writing skills, and the ability to use evidence, students write a letter to their appropriate official. Initially, we had students write a letter on a topic chosen by the faculty, such as immunizations. Still, we found that giving students a choice would be more beneficial to the adult learner. Students now pick a bill, legislative issue, or idea for new legislation and write a professional letter that is often delivered via email. Students are encouraged to mail their messages to the appropriate official, void of the university name. This allows the letter to come from the student, independent of the university, so as not to confuse the elected official that it is the university’s influence.
Lastly, students are provided an opportunity to attend the Arizona Nurses Association Lobby Day at the Arizona State Capital with a faculty member. This
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January, February, March 2020 Arizona Nurse • Page 11is optional as students have various school commitments and levels of political activism. Dr. Cheryl Schmidt recently led a group of students during the lobby day. See Appendix C.
Student FeedbackStudent feedback was taken into consideration during this process of
threading political activism content and assessments. During the piloting of new assessments/assignments, we received many positive comments. Regarding the implementation of letter writing, a couple of comments (used with permission) were:
“I felt the assignment was incredibly helpful in aiding us to use our voices as nurses to impact a greater need.”
“I believe this assignment should be included in the curriculum from here on out—It allowed students to become more familiar with different laws and policies in health care, as well as gave us an opportunity to speak up about the things that matter to us.”
ConclusionThe topics and assignments that enhance political activism guide our
students to a place where they can become future nurses who impact healthcare policy for a stronger healthcare system and community. The stages of political activism are a good tool to guide, reflect, and assess one’s political activism. Within our curriculum, we built a system that moves the students to the next stages as they complete the assessments/assignments. As one student commented, “…By the end of the semester, I believe I will be at the buy-in stage. Most of the credit will go to this class because I have learned so much in this time about politics…”
Appendix A
Stages of Political Activism Reflection Assignment
Directions:• Use the following table of the Stage of Political
Activism to select your current stage• Answer the two questions below the table• Use the link below the table, as well as
Stanhope and Lancaster (2018), to assist with question 2.
Stage of Political Activism
Description of Stage
Apathy The apathetic nurse doesn’t belong to professional organizations, takes little or no interest in legislative politics as they relate to nursing and health care, and may not be a registered voter.
Buy-in The nurse starts to recognize the importance of activism within professional nursing organizations but hasn’t taken an active role in these organizations. He or she starts to become interested in legislative politics related to critical nursing issues but takes little or no political action. Nurses at this stage are likely to be registered voters.
Self-interest The nurse seeks involvement in professional organizations to further his or her career and seeks to develop and use political expertise to promote professional self-interest.
Political sophistication
The nurse is active at the professional organizational level and may hold an organizational office at the local or state level. He or she has moved beyond self-interest and recognizes the need for activism on behalf of the public.
Leading the way The nurse serves in an elected or appointed position at the state or national level of a professional organization. To provide true leadership on broad healthcare interests within legislative politics, he or she may seek appointment to policymaking bodies. Some nurse-leaders seek election to political office.
Reflection Questions 1) What stage do you identify with and why?2) How can you move up to the next stage? Explain
with examples.
Appendix B
Elected Official Worksheet Directions: Fill in the information below
Student name and zip code:Find your state and federal legislative districts: https://azredistricting.org/districtlocator/
(Note: Legislative district is state and Congressional district is federal)
Legislative District number:
Congressional district number (United States Congress):
State Senator
https://www.azleg.gov/MemberRoster/?body=S
State Senator Name:
Committees:
Sponsored bills (select a few of interest):
Contact information:
State House of Representatives
https://www.azleg.gov/MemberRoster/?body=H
State House Representative (1):
Committees:
Sponsored bills (select a few of interest):
Contact information:
State House Representative (2): Committees:
Sponsored bills (select a few of interest):
Contact information:
Federal Senators
https://www.senate.gov
Federal Senator (1):
Committees:
Sponsored bills (select a few of interest):
Contact information:
Federal Senator (2):
Committees:
Sponsored bills (select a few of interest):
Contact information:
Federal House of Representatives https://www.house.gov/
House Representative:
Committees:
Sponsored bills (select a few of interest):
Contact information:
Appendix C
Lisa Jaurigue, PhD, RN, CNECheryl Schmidt, PhD, RN, CNE, ANEF, FAAN
ReferencesAmerican Association of Colleges of Nursing. (2008). The Essentials of Baccalaureate
Education for Professional Nursing Practice. Retrieved August 21, 2019 from https://www.aacnnursing.org/Portals/42/Publications/BaccEssentials08.pdf
Quad Council Coalition Competency Review Task Force. (2018). Community/Public Health Competencies. Retrieved August 21, 2019 from http://www.quadcouncilphn.org/documents-3/2018-qcc-competencies/
Page 12 • Arizona Nurse January, February, March 2020
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Intermittent Fasting:
Is it right for you?Terri-Ann Kelly, PhD, RN, CPT, FNS, Assistant Professor, Rutgers University—Camden, NJSNA Region 5 Member and Healthy Nurse Healthy New Jersey team member
Reprinted with permission from New Jersey Nurse October 2019 issue
Everywhere you turn, you’ll find articles or hear celebrities touting the benefits of intermittent fasting (IMF). Unlike traditional diets, with IMF, the focus shifts from “what should I eat” to “when should I eat?” IMF, also known as cyclic fasting, is a method of eating that cycles between periods of fasting, with either no food or significant calorie reduction, and periods of unrestricted eating. Extensive research suggests that IMF increases fat burning and weight loss by using up fat stores as fuel, helps regulate blood sugar levels, supports a healthy inflammatory response, promotes heart health by lowering LDL (“bad”) cholesterol and triglycerides, and supports cognitive health.
The most common types of IMF you can include in your daily routine include:
• 16:8 fasting, also known as time-restricted feeding: fast for 16 hours every day and limit your eating to an eight-hour window. Most often, individuals skip breakfast but eat lunch and dinner.
• Alternate-day fasting: eating only every other day. On the fasting days, you can choose to eat no food at all or limit caloric intake to 500 calories.
• 5:2 diet, also known as the fast diet: For 5 days of the week you eat normally, and for two nonconsecutive days, you restrict your caloric intake to 500-600 calories.
• Eat Stop Eat: Choose one or two days out of the week where you only consume non-caloric beverages (ex. herbal tea, water, black coffee) for 24 hours. For example, eat nothing from dinner one day until dinner the next day. On non-fasting days you can eat normally.
Is IMF right for everyone? Absolutely, NOT! Fasting would not be appropriate in instances where extra calories or nutrients are needed for growth and development during childhood or adolescence and when pregnant or breastfeeding. Also, individuals should abstain from IMF if they have conditions such as gallstones or thyroid issues, eating disorders that involve unhealthy self-restriction (anorexia or bulimia nervosa), and use medications that require food intake. As always, it’s best to consult with your healthcare provider to determine if IMF is appropriate for you.
As a beginner, the 16:8 method is the easiest to implement. Below are my top tips for success with 16:8:
• Start your day off with a glass of water and continue to drink water until you’ve reached your goal. Staying hydrated is important as it will help curb your appetite and make fasting much easier.
• When you break your fast, make sure you eat plenty of fiber and nutrient-dense whole foods, and try to keep your intake of sugary beverages and high carbohydrate foods to a minimum.
• Track your daily fasting with an app such as the Zero Fasting Tracker.
• Stay consistent and don’t expect overnight weight loss.
If you’re looking for a way to lose weight while also getting additional benefits, there are many types of IMF to choose from with variations to fit any lifestyle. But also keep in mind that IMF may not be for everyone!
Good luck and happy fasting!
Reference: Varady, K.A., Bhutani, S., Klempel, M.C., Kroeger, C.M.,
Trepanowski, J.F., Haus, J.M.,…Calvo, Y. (2013). Alternate day fasting for weight loss in normal weight and overweight subjects: A randomized controlled trial. Nutrition Journal, 12(1).
Kathryn Handy, DNP, RN, CNEReprinted with permission from Maryland Nurse
November 2019
In today’s complex health care system, a competent nursing workforce possessing the knowledge and skills to provide safe, high quality care, is essential. In 2010, the Institute of Medicine (IOM) released the landmark report, The Future of Nursing: Leading Change, Advancing Health, on the nursing profession and identified the need for nurses to take on leadership roles in all settings to meet the ever increasing demands of our changing health care system. Nurse academicians and clinicians continue to heed this call, advancing education and engaging in a wide range of professional development activities that support the evidence-based recommendations of the IOM. Credentialing and certifications validate the skills, knowledge, and abilities nurses need to succeed and create change in this ever-changing profession.
Utilizing a standard process of credentialing nurses ensures that nurses, healthcare providers, consumers, and other relevant entities understand the significance and value of credentials. To avoid confusion, there is a specific procedure for displaying credentials in a uniform manner. The American Nurses Credentialing Center (ANCC) provides a step-by-step guide to understanding and displaying your nursing credentials (ANCC, 2013).
Every day we see the multiple streams of initials within a nurse’s signature. There is a vast array of credentials to note. Educational degrees include doctoral degrees (PhD, DrPH, DNS, EdD, DNP), master’s degrees (MSN, MS, MA), bachelor’s degrees (BS, BSN, BA), and associate degrees (AD, ADN). Licensure credentials include RN and LPN. State designations or requirements recognize the authority to practice at a more advanced level in that state and include Advanced Practice Registered Nurse (APRN), Nurse Practitioner (NP), and Clinical Nurse Specialist (CNS). National certification, which is awarded through accredited certifying bodies such as the ANCC, the National League for Nursing (NLN), or the American Organization for Nursing Leadership (AONL), includes Family Nurse Practitioner-Board Certified (FNP-BC), Certified Nurse Educator (CNE), and Certified in Executive Nursing Practice (CENP) respectively. Awards and honors that recognize outstanding achievements in nursing include those such as Fellow of the American Academy of Nursing (FAAN) and Fellow of Critical Care Medicine (FCCM). Other possible recognitions include non-nursing certifications that recognize additional skills, such as the EMT-Basic/EMT, awarded by the National Registry of Emergency Medical Technicians. As nursing continues to advance as a profession, the use of credentials to designate and to identify the levels of attained education, licensure, certification and achievement as a professional is essential.
Displaying credentials correctly is vital. The preferred order of displaying one’s credentials is the following: (a) highest degree earned; (b) licensure; (c) state designations or requirements; (d) national
A Guide to Displaying Nursing Credentials
certifications; (e) awards and honors; and (f) other recognitions. Why is this so important? The order is placed in regard to degree permanence. One’s educational degree is placed first as it cannot be taken away except under extreme circumstances. Next, the licensure credentials and the state designations or requirements, which are required for practice. These are generally time limited and need to be maintained through renewals and continuing education. Then finally, the awards, honors, and other recognitions which are voluntary and not required for practice (ANCC, 2013)
This seems easy enough, right? It may be helpful to add a few points of clarification here. You might ask, do I have to place all my credentials on everything I sign or include in professional speaking and writing endeavors? With legal documents, such as prescriptions and documentation within the medical record, you must use the credentials required by your particular state for your area of practice. In professional endeavors such as speaking, writing for publications, or providing testimony before a legislative body, you should use all your relevant credentials. Please note that journals sometimes order credentials differently, so it is appropriate to conform to their specific style. Or perhaps, what if I have multiple credentials of the same type? In this case you would list the highest education degree first and if your second degree is in another relevant field, you may choose to list it as well. For example, a nurse executive might choose Nancy Gordon, MBA, MSN, RN. Note here that the highest non-nursing degree is listed first followed by the highest nursing degree. A nurse who has a master’s in a non- nursing field might choose Anne Peterson, MEd, BSN, RN. Remember though, if you have a doctorate and a master’s degree, omit your baccalaureate degree. If you have multiple nursing certifications, they may be listed in the order you prefer. Do consider listing them in order of relevance to your practice or in the order they were obtained, with the most recent first. Always list non-nursing certifications last.
Properly displaying credentials enables nurses to demonstrate their specialty expertise, professionalism, and validate their knowledge to employers, patients, colleagues, and students. Through education and professional development, we enrich ourselves, the future nursing workforce, ensure the provision of safe, high quality, patient-centered care, empower the nursing profession, and have the ability to promote change. Wear your credentials proud. Be proud of your accomplishments; acknowledge them and allow others to acknowledge them.
ReferencesAmerican Nurses Credentialing Center. (2013). How
to display your credentials. Retrieved from https://www.nursingworld.org/~ 49636a /globalassets/certification/certification-specialty-pages/ancc-credentialsbrochure.pdf
Institute of Medicine. (2010). The future of nursing: Leading change, advancing health. Retrieved from http: //books.nap.edu/openbook.php?record_id=12956&page=R1
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Page 14 • Arizona Nurse January, February, March 2020
New & Returning AzNA MembersSeptember – November 2019
Apache JunctionTarie Sosa
AvondaleApril Murrieta
BensonNicklett Johnston
BouseMaria Martinez
BuckeyeTasha MayChristian PinedaKellie PorterKatrina Taylor
Casa GrandeAlexandra KenuamPatti Reno
Cave CreekJill GrafKathleen Harrington
ChandlerAikaterini BoukouvalaDenise DionShawna HarrisonSandra KirkbyLaura Vidale
CoolidgeRobin Mills
DeweyKelli NealLois Porter
El MirageEsthela Palacios Carrillo
FlagstaffShawn BowkerBenjamin KeelerLisa Skow
FlorenceKeridwyn Bailey
Fountain HillsMary PoquetteMartha Thomas
GanadoWanda Begay
GilbertAmber BrasfieldMaria DavisTracey EscalanteRochelle FranksMonica HulseyMolly LukeFelicia McCleanClaire MillsMelissa RossOluwaseun SanyaJacqueline SoetanKevin Turnage
GlendalePatricia BirminghamCynthia DecesareKimberly Del BosqueBriane MapePamela PaduanoMaryann PappasAnnette SoteloKelly Waldo
Golden ValleyScott Ewing
GoodyearAlvina AlexanderKathryn GoshornNika HickeySharron HierPurity SangVerna SchadStephanie SelvigMalina SilvaApril Warden
Green ValleyKathleen Alves
HerefordJill Bachman
Keams CanyonDenise Blackrock
KingmanMary BeckFides CuetoAutumn Sexton
Lake Havasu CityKelsy GilmoreChristy Richmond
LakesideAlena Thompson
LaveenNatalie BarajasDarlene BrownAugustin Harelimana
Litchfield ParkFrancine DeFurioMary GarbaczLisa HernandezDawn Walker
MesaCharmin AllenCheri BeersMarie BrewerAmanda BrownStephanie CastilloCynthia ChristakisAlisha CourtneyNatalie HeywoodSara HillCara LeivdalEmily LesueurAmanda LewisDenise MeitlStephanie NiemyjskiAnthony OlorunsolaHeidi Parker
Melodi PriddyAmaryllis RandleLisa RueterKatelyn ThorntonKatrina ValentinoDree Wilkinson-May
New RiverDiana Cash
Oro ValleyTonia IsotaloKaylani JacksonIngrid LeclaireRene LoveMerrie Rheingans
PaysonBrianne Hardman
PeoriaLinda BainesBeverly EasterwoodEssie LearnJames NewmanAmanda ShackelfordSamantha SwartzMaricris Tallant
PhoenixArlene AlvarezShizuka BarclayPatricia BurrillBreanne CarmackRaul GonzalezRobyn GroppiRobyn HaleJennifer HanischRobert JozwiakAriana Juarez-MoncadaTadrah KaskieLilian LaimoPenny LeeElizabeth LorenzoMelinda MarraKarla MiramontesJudy NodingKristi NorrisPearlene PanucoKatherine RoatCorie RogersKuldeep SinghKomal SinghSara SmithJessica SobczakLachelle TorreLaura WheelerJohn WinchesterSusan WoolfendenJenifer WuesteBlaire Zamboni
PinonRoshelle Bekaye
PrescottJennifer HemphillColleen Wilson
Prescott ValleyJoseph Rosales
Queen CreekJoyce Rosette
Rio RicoVanessa AguirreJulie Higuera
RooseveltJennifer Power
Round RockKathleen Atene
SahuaritaKathleen KaraszewskiCheryl Webb
ScottsdaleMichael AmorosiaJessica ArkinBethany BiardiMarbella Campo-SifuentesKrista CashLauren ColnJess GuttellJames HinkleCheryl HurleyMichael KuykendallJill LeblancKaitlyn MannAnne MonroeCindy MoralesMichele NorrisJennifer PackStephanie ResslerZia Tyree
SedonaStacy Davidson
Show LowElizabeth Klein
Sierra VistaSky EspeLessa Greenwood
SnowflakeJeannie Khane
Sun CityKristal Pierce
SurpriseHazel BeckhamKaitlyn BierhausNelida FructuozoPaula MitchellAleksandra Yearwood
TempeMichelle ArciniegaLe BormanStephanie SeinDaniel Starkey
TollesonChristina MolinaSherri Rhodes
Tuba CityJohn Everett
TucsonJennifer AlexanderLisa BakerAna Ben ShabatTimothy BurrFelix CanezLorraine Earley-ThibautRebecca HooverNatalie LewisClaudia LucasToyin MarcusKaileen MartinMarcy MilbrandtLisa OrrDebra PainterKatie SanduskySarah Santa CruzYanina ShamesSue SimoRachel TaiepisiBarbara TaylorMorgan Wilkinson
VailJulie EasterdayClaudia SanchezLaura Ybarra
WaddellHolly Franklin
Window RockEmmeline Thompson
YumaShawnita CastanedaKim KellandMonica OrdazAlayna RagainJudith ReavesCeliamarie RenteriaJeffrey RiocasaDeborah ShubickRoxana SilvasTarisai Zi8
Renewing your Nursing License:
Changes You Need to Know About
Are you aware that the licensing process
has changed to a confidential and secure cloud-based system called The AZ Nurse Portal? Every nurse with an Arizona license needs to renew that license every four years through the Arizona State Board of Nursing (AZBN).
Create an Account NowIf you have not yet created an account
on AZ Nurse Portal, please get online as soon as possible and create an account, even if it’s not time for you to renew yet: www.AZBN.gov. The portal is where you will apply for renewal, apply for any new credential types, request name or address changes, or initiate contact with AZBN electronically. Access the AZ Nurse Portal through the homepage of the AZBN website: www.AZBN.gov
No more Mailed Licenses or CertificatesTo protect the integrity of the license or
certificate, AZBN has stopped printing and mailing paper licenses and certificates. All information related to your licensure and/or certification is available through the portal. You will be able to print out this information through your AZ Nurse Portal account.
Instructional VideosInstructional videos on how to register
and submit an application can be found on the Arizona State Board of Nursing website at https://www.azbn.gov/instructional-videos.
January, February, March 2020 Arizona Nurse • Page 15
Apache JunctionKhirstin LittenBrenda Vigue
AvondaleLatif Mustapha
BensonDebra Haber
Billings, MTGregory Titensor
BuckeyeDoreen Farley
Casa GrandeBrandi GarciaCorrine Jacobs
ChandlerJacqueline GualtieriSarah PortleAllegra Shepherd
Chino ValleyRebecca Risaliti
CottonwoodShelley Gosnell
DeweyCrystal McCarthy
DouglasMartha Van Driel
Endicott, NYGalen Richmond
FlagstaffMoriah KirkmanDawn Rivas
FlorenceTress Goff
GilbertMisty AlbertLori BestWendy CameronColleen Gavigan
Melanie OglesbyBrent ShepardsonEva-Bettina Tovstiga
GlendaleHeather BelcherTess DavisAmanda HolleJanet O’BrienAllison StokesCaryn UnterschuetzSharon Voss
GoodyearTavierre FreemanDaniel LingleHeather MoralesPaula Piccoli
Lake Havasu CityKaisu Fisken
Litchfield ParkPhillip Hinkel
MaricopaKelly Huffstutler-Petty
MesaDebbie EvansJena LomasneyMarialena MurphyJosephine PozonMarlene Wilson
Newport, ORKelly Fath
Palmdale, CAShirlene Gines
PeoriaJacqueline AndresVicki BradshawMinnerva CarrozJo Lynn GroeningAlicia KimlingErica MendezMichelle Taylor
PhoenixPiedad Blake
Two Year Anniversary MembersSeptember – November 2019
Brandi BreukerRuth CanadaMichael DitsworthDoree GlantzErica GrajalesCarol GravesIsaac HensleighShirley HudsonTiffany MercerSandra RamosHeather RyanAllyson SambachLisa SmithMichell SorleyAlexandra SullivanAmanda Taylor
PolaccaSusannah Spero
PrescottRosangela Buckle
Prescott ValleyTracy Real
Queen CreekTracy ChesneyKathleen Hutter
RimrockDiane McCoy
SahuaritaLaci CainYulianna Inzunza
ScottsdaleDenise BoyleShannan BridgewaterCynthia CrockettSusan DelnocePeggy HannelBrigid KileyLisa KilleenNeejay OgarSteve PilkingtonJoanne RuizEmilia SpeerBobbi WinterJeannine Ziomek
Sierra VistaMarybeth Harper
Silver SpringsAndra Matthews
Sun CityHolly LuskMary Walsh
Sun City WestTanya Carroccio
SurpriseMartha CarsonJessica CoatsKyle Colburn
TempeDanielle PutrowMatthew Rhodes
TollesonCherry Cook
TucsonFlorence GoresJenice Ria GuzmanLaura HutchesonMaryann JuarezWanda LarsonJennifer PowersJonathan ResilleAngel RiversCarrie RubalJoan ShaverKatharine Strangis
VailNightingale JordanDennis Ondrejka
YoungtownKimberly Thompson
YumaPatricia GonzalezJaime HutchinsEvelyn KuidaTracy MacdonaldKilene MenvielleLucrecia Mercado-Dobson
AzNA’s Superstars
Happy Anniversary to our dedicated AzNA members celebrating these special
milestones for this past quarter:September – November 2019
5-Year MembersKaty-Marie BeckerJacque CrossonRebecca DailyElizabeth DavidMary DavisAudrey ElliottCynthia FarrLori FunkeLouannie GodinezLeAnne GundySharen KeelerLesly KellyCynthia KoopsenJanet MarVictoria MavungaRyan-Michael McKenzieSarah MoorePamela NolandElla PooreChristina RidingsEvelyn RomanDyan SinclairAlice SiscoPatricia StewartLorna TanLuisa ValenzuelaPatricia WhiteCaitlin Wright
10-Year MembersJennifer DrewelCharissa ElliottDwight FaughtDenice GibsonCrystal GrysKathleen InfeldKaniz IslamMichelle PageJulie PascenteEileen SmithShelly TannehillBrenda Wilkins
15-Year MembersJoAnn AppleyardCristina ChiaburuDavina GlaserPatricia MewsJanet RinehartShirlee SnyderGreg Zobell
20-Year MembersNikki O’Daniels
25+-Year MembersMarsha AshurstMarilyn BagwellMay BrunerEllen CavanaughDebra ClaycombKathryn DiPierroRose EmeryDana EpsteinBarbara FargotsteinCarol FeingoldTherese FloodJudith GallobAnn GutheryCarol HeimannJudy HerrimanMary HerringKaren HolderEvelyn JacobsDenise JohnsonMarilyn LindellPatricia MaurerSusan MottaDeirdre MountjoyPeter PeilPamela ReedDorothy RileyPatricia RothCheryl SchmidtSharon Sheehan- BifanoCarol StevensMary WaltersJean Wictor
Curious About Congregational Health?
Duet trains nurses how to combine their professional skills with their faith in order to promote health, healing, and disease prevention within their congregations and the communities they serve.
Congregational Health Information Session
Tuesday, February 25Noon-1:30 p.m. or 6-7:30 p.m.
Spring 2020 Foundations of Faith Community Nursing Course
Part 1: Thursday, Friday and Saturday, March 26, 27, 28Part 2: Friday and Saturday, May 1 and 2
7:45 a.m.-5 p.m.
Both events take place at Duet:10000 North 31st Avenue,
Suite D200, Phoenix, AZ 85051
To learn more, contact April Polley at [email protected] or Anne Varner at [email protected].
www.duetaz.org/congregational-health
