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Time for License Renewal New “Retired” Option . . . . . . . . . . . . . . . . . . . . . . . . 2Commentary—A Call to Prevent Harm to Children’s Brain Development . . . . . . . . . . . . .3Unpacking the BON Website . . . . . . . . . . . . . . .4It’s Going to be a Busy Fall . . . . . . . . . . . . . . . .5UAA School of Nursing Update . . . . . . . . . . . . .5Health Policy Corner . . . . . . . . . . . . . . . . . . . . .8
Fairbanks Breastfeeding Coalition Art Exhibition . . . . . . . . . . . . . . . . . . . . . . . . . . 9The Bulletin Board . . . . . . . . . . . . . . . . . . . . .10Nursing Coalition Praises Commission on Care Recommendations to Improve Veterans’ Healthcare . . . . . . . . . . . . . . . . . . . . . . . . . . .13Are You in the Know? . . . . . . . . . . . . . . . . . . .14Up and Coming Event Calendar . . . . . . . . . . .15
Volume 4 • No. 3 September 2016The Official Publication of the Alaska Professional Nurses Organization
Quarterly publication direct mailed to approximately 8,000 Registered Nurses and Licensed Practical Nurses in Alaska
Nurses and the March of Dimes:
A Critical Connection
Page 5
Signing Day—July 6
Page 6
Congratulations Graduates
2016
Page 7
By Lynn Hartz, MSN, APRN
Part one of ‘Alaska and the opioid epidemic’ reviewed prescription opioids; codeine, hydrocodone, oxycodone, morphine and fentanyl and the discovery that over prescription of opioids in the U.S. has led to an epidemic of deaths due to opioids.
Since the June issue, there has been continued action regarding opioid use and abuse on the federal and state level. In addition to the CDC release of recommendations for prescribing opioids for chronic pain last spring,1 congress passed the CARA act (cadca.org), President Obama formed a new interagency taskforce aimed at making sure insurance programs treat medical and mental health coverage equally, the state convened an Alaska Opioid Policy Task Force tasked with presenting recommendations to the executive and legislative branches before the end of the year, and finally, Senator Dan Sullivan of Alaska convened a Summit on Conquering the Opioid Crisis last August in the Mat-Su.2
Alaska and the Opioid Epidemic : Part TwoWhat Nurses Need to Know
Lynn Hartz
Dr. Vivek Murthy, U.S. Surgeon General on left, talks with Dr. Jay Butler, Chief Medical Officer
and Director of the Division of Public Health at a Fireside Chat at the Alaska Wellness Summit—
Conquering the Opioid Crisis, August 2016.
Vivek Murthy, MD, U.S. Surgeon General, speaking at the Summit, described his belief in a policy of prevention. He hopes to educate prescribers by sending out a letter in the fall on safe opioid prescribing along with a pocket reminder. In addition, later this year the first ever report on substance abuse will be issued from the office of the Surgeon General.
In this issue we will:• review the options available to Alaskans
with opioid use disorder who seek treatment
• introduce the Prescription Drug Monitoring Program to nurses and the changes that are taking place due to passage of SB 74
• describe the changes made in law by SB 23• list CE resources on opioids for nurses.
Addressing the Harms—Medication Assisted Treatment
A person who has become addicted to an opioid and seeks treatment must first get an evaluation as different medications are available. The goal of therapy is harm reduction and maximizing function. According to Sarah Spencer, DO, we need to develop a chronic disease model for addiction just as we have done for diabetes and depression. Just as insulin will manage but not cure diabetes, opioid replacement will not cure the patient, it can suppress symptoms of craving and withdrawal to allow patients to make behavioral changes that will rewire the brain reversing some of the changes of addiction3.
The following descriptions are very brief on a complex subject and the reader is advised to go to the references for more in depth information.
Medication-Assisted Treatment (MAT) is the use of medication, combined with counseling and behavioral therapies, to provide a holistic approach to the treatment of substance use disorders.4
Those patients meeting the criteria for opioid use disorder have three options for MAT depending upon the shared decision making of the clinician and patient.5
1. Methadone, an opioid, is a schedule II opioid agonist that binds to various opioid receptors producing analgesia and sedation. It lessens the pain of withdrawal and blocks the euphoric effects of opiate drugs such as morphine and oxycodone. Methadone is carefully regulated and can only be delivered through a SAMHSA-certified opioid treatment program. Patients are closely monitored and may be in residential treatment though most are seen in outpatient programs. Eventually patients may be able to take methadone at home between visits to the program. Treatment can last from a year to several years.4,5, 6
2. Buprenorphine or Suboxone (buprenorphine/naloxone) is a schedule III opioid partial agonist/antagonist. It reduces symptoms of craving and withdrawal without producing
Alaska and the Opioid Epidemic continued on page 11
Page 2 • Alaska Nursing Today September 2016
Contact AKPNOAlaska Professional Nurses Organization
200 W. 34th Ave. #118Anchorage, AK 99503
www.akpno.org
The Alaska Professional Nurses Organization is a statewide nursing society dedicated to improving the health of all Alaskans through fostering nurse leadership and excellence in nursing practice.
Board of DirectorsPresident Barbara Berner EdD, MSN, FNPVice President Mary Stackhouse CLNCSecretary LeMay Hupp MPHTreasurer Debbie Thompson BSN, CNOR
Directors at Large Pat Dooley BSN, CHPN, MHSA
Editor: Lynn Hartz MSN, ANP [email protected]
Author Guidelines:
ArticlesAlaska Nursing Today welcomes original articles for publication. Preference is given to nursing and health related topics in Alaska. Authors must identify potential conflicts of interest, whether financial or of other nature and identify any commercial affiliation if applicable. Resources, including websites should be listed at the end of the article. Photos may be sent as a .jpg file and become the property of AKPNO.
Editorials/Commentary/ Letters to the EditorLetters, comments, questions or opinions about nursing or health care in Alaska are a wonderful way to share information and viewpoints with colleagues across the state. Send your submission via email. Letters must be 500 words or less and may be edited for length, clarity and grammar. Editorials and Commentary do not have a word limit at this time though they are also subject to editing. The ANT is published every three months so be careful about sending time sensitive material.
AKPNO has the right to accept, edit or reject proposed material. Materials may not be reproduced without written permission of the Editor.
All submissions may be sent [email protected]
Publishing Information and Ad ratesAlaska Nursing Today is published quarterly every March, June, September and December.
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]. AKPNO and the Arthur L. Davis Publishing Agency, Inc. reserve the right to reject any advertisement. Responsibility for errors in advertising is limited to corrections in the next issue or refund of price of advertisement.
Acceptance of advertising does not imply endorsement or approval by the Alaska Professional Nurses Organization 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. AKPNO and the Arthur L. Davis Publishing Agency, Inc. shall not be held liable for any consequences resulting from purchase or use of an advertiser’s product. Articles appearing in this publication express the opinions of the authors; they do not necessarily reflect views of the staff, board, or membership of AKPNO or those of the national or local associations.
Time for License RenewalNew “Retired” Option
LPNsThe renewal period for LPNs ends September
30. There is no grace period according to the Board of Nursing website. Go to www.nursing.alaska.gov if you have not renewed or call 907-269-8160.
RNsThe current renewal period for RNs is
December 1, 2014-November 30, 2016. The RN license will lapse after November 30, 2016. There is no grace period. To renew online go to www.nursing.alaska.gov. According to Sharyl Toscano, Board member,” We are currently in a renewal year. As you fill out your renewal it would be a good idea to keep a file with documented evidence of your CE, volunteer, and/or other activities identified in your renewal as meeting the renewal criteria for the year. Keep this in a place that is accessible to you so that you can access it quickly in the event of an audit.”
If you have questions about the statutes and regulations, the complete nursing statutes and regulations are available at www.nursing.alaska.gov (see Board of Nursing Links on the left side of the screen).
APRNsSee above for general information on RNs.
In addition to the RN continued competency requirements, APRNs must hold a current national certification for each of the roles and population foci in which the applicant is seeking renewal. In addition, they must include certification of completion during the previous two years of 12 hours of CE in advanced pharmacotherapeutics and 12 hours of CE in clinical management of patients (12 AAC 44.440.).
New! “Retired” OptionEffective August 10, 2016, a nurse who has an
active and unencumbered license, may apply for a retired nurse license status. They may use the title LPN, Retired, RN, Retired, APRN, Retired etc. but may not practice.
A retired nurse license is valid for the life of the holder and does not require renewal. It may be considered an honorary title similar to what is used in the military services. It may also be used when writing for publication and public speaking. It may not be used to practice or volunteer nursing services. A retired licensee who wishes to return to active nursing must meet the requirements of lapsed or reinstatement of a license. There is a one-time, $165 fee. Interested nurses should contact the Board of Nursing.
Live and work in beautiful Homer, Alaska!Homer is on the southern shores of the Alaska Kenai Peninsula. A quaint town nestled on the beautiful Kachemak Bay offering breathtaking views of glaciers, mountains and wildlife. It has something for everyone: adventure, culture, scenery, or even a little bit of solitude.
South Peninsula Hospital is a modern facility with 22 Acute Care beds and an attached 28 bed Long Term Care nursing facility. We are seeking dedicated and talented nursing professionals to join our diverse team:
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October 15th at the BP Energy Center, Birch Room, Anchorage, 8a-5p Earn 7.5 CEs!
Theta OmicronAlaska chapter of STTI
Presents:
Using Evidence in Nursing Practice Every Day
September 2016 Alaska Nursing Today • Page 3
By Pamela Miller, Executive Director of ACAT
Children in Alaska are especially vulnerable to chemical exposures that may affect their present and future lives. Compelling scientific evidence links exposures to certain toxic chemicals with learning and developmental disabilities. The north is a hemispheric sink for persistent chemicals that are transported on wind and ocean currents and accumulate in the bodies of fish, wildlife, and people. Also, our homes are insulated and closed against the cold for much of the year, thus exposing children to harmful chemicals that are released into the indoor environment from household products such as electronics, furniture, toys, building materials, and through combustion sources. Contributing to the problem are the hundreds of hazardous waste sites associated with military and industrial operations, as well as poorly managed landfills, burn boxes, and incinerators.
On July 2016, a unique collaboration of leading scientists, health professionals, and children’s health advocates issued a historic scientific consensus statement about the harm to children’s brain development associated with exposures to certain toxic chemicals prevalent in our homes, air, water, and food. This collaborative effort, Project TENDR (Targeting Environmental Neurodevelopmental Risks) first convened in 2015 because of our concern about the now substantial scientific evidence linking toxic chemicals to neurodevelopmental disorders such as intellectual and learning disabilities, autism spectrum disorder, and attention deficit hyperactivity disorder (ADHD). The consensus statement is an urgent call to action for elected officials, agency policymakers, and businesses to take a new approach in protecting our children’s health and to ensure that all children can reach their fullest potential.
Project TENDR is led by Co-Directors Maureen Swanson, leader of the Healthy Children Project of
Commentary—A Call to Prevent Harm to Children’s Brain Development
Pamela Miller
the Learning Disabilities Association of America and Irva Hertz-Picciotto, professor of epidemiology and environmental health at UC Davis Department of Public Health Sciences. I was honored to be invited by Ms. Swanson and Dr. Hertz-Picciotto to be a part of Project TENDR and agreed to participate because of my concern about the special vulnerability of Alaska’s children.
The consensus statement highlights examples of chemicals and pollutants that are contributing to children’s learning, intellectual, and behavioral impairment, including:
• Organophosphate (OP) pesticides• Polybrominated diphenyl ether (PBDE)
flame retardants• Combustion-related air pollutants, which
generally include polycyclic aromatic hydrocarbons (PAHs), nitrogen dioxide and particulate matter
• Lead• Mercury• Polychlorinated Biphenyls (PCBs)
Alaska’s elected officials and policy makers should heed the call for urgent action. And the Alaskan public has some important opportunities to hold our elected officials and agency policymakers accountable. This year, the Alaska State Legislature failed to pass the Toxic-Free Children’s Act (SB 111/HB 199) introduced by Senator Bill Wielechowski and Representative Harriet Drummond. This act would have prevented the use of ten flame retardant chemicals in children’s products and toys. These include PBDEs and other toxic chemicals that are known to be associated with learning and developmental disabilities, cancer, and reproductive impairment. The chemicals confer no proven fire safety benefits and make household fires more toxic and dangerous for first responders. The Toxic-Free Children’s bill is widely supported by such groups as the Alaska Professional Firefighters Association, Alaska Fire Chiefs Association, Alaska Nurses Association, the Alaska Professional Nurses Organization, the Alaska Federation of Natives, the Alaska School Nurses Association, and The Arc of Anchorage. We hope that Alaskans will contact their legislators in advance of the next session and that this important measure to protect children’s health will pass in 2017.
The Governor’s Council on Disabilities and Special Education recently prepared a draft of a State Five-Year Plan that includes important goals concerning services, employment, early intervention, education, and health care. It is imperative for the Council to include an additional
goal of reducing and eliminating exposures to chemicals that contribute to neurodevelopmental harm, thereby focusing on prevention and protection of the developing brains of children.
We welcome everyone who has concern about children’s health to participate in a Children’s Environmental Health Summit on October 5 and 6, 2016 at Alaska Pacific University in Anchorage. The purpose of the gathering, convened by Alaska Community Action on Toxics, is to bring scientists, health care professionals, tribal leaders, policy makers, teachers, parents, students, and advocates together to discuss the latest science and develop recommendations for policy actions to protect the health of children. Several of the scientists and health professionals who have been a part of Project TENDR will be speaking at the summit. This summit will address environmental health and health disparities of children “at the top of the world” and ways that we can work together to ensure healthy homes, child-care facilities, schools, and communities. Together, we will develop recommendations for actions that must be taken to improve the health of current and future generations of Alaskan children in the areas of education, policy reform, health care, research, and prevention. For more information and to register, please go to www.akaction.org. (Although registration was planned to close September 5, late registration may still be available).
The TENDR Consensus Statement, authors, and endorsing medical societies was published in the Journal of the National Institute of Environmental Health Sciences and can be found at: http://ehp.niehs.nih.gov/EHP358/
[Pamela Miller is the Executive Director of Alaska Community Action on Toxics. Contact information: [email protected]; (907) 222-7714.]
[Reprinted from ADN 7/18/16 with permission of the author.]
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This season, protect yourself—and those around you—by getting a flu vaccine.
For more information, visit: http://www.cdc.gov/flu
I won’t spread flu to my patients or my family.
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Even healthy people can get the flu, and it can be serious.
Everyone 6 months and older should get a flu vaccine. This means you.
This season, protect yourself—and those around you—by getting a flu vaccine.
For more information, visit: http://www.cdc.gov/flu
For more information, visit: http://www.cdc.gov/flu or call the Alaska Immunization Helpline at 1-888-430-4321
Page 4 • Alaska Nursing Today September 2016
By Lynn Hartz, MSN, APRN
The Alaska Board of Nursing website is loaded with information though sometimes it may seem difficult for the newcomer to find things with such a large amount of information. In this article, we will deal with just one subject and one part of the website, the Board of Nursing Advisory Opinions. This article will cover the Advisory Opinions of 2015.
The Board of Nursing is unique among the professional boards in Alaska in that it has been allowed for more than 35 years by the legislature (that is by statute) to give advisory opinions to its licensees, not just make regulations. An advisory opinion is not a law, but it is an official opinion of the Board of Nursing on the practice of nursing in Alaska therefore should certainly be adhered to.
In recent years, the advisory opinions have sometimes been used by the Board as an indication of their ideas prior to being made into regulation. Advisory opinions are much easier to initiate and change than regulations and take less time. Therefore, if you are an expert in areas you see are being dealt with by the Board, you should send in your commentary, analysis and references regarding Advisory Opinions as these can be helpful.
To find the Advisory Opinions, go to www.nursing.alaska.gov, where you will see the home screen of the BON. (See Fig. 1)
Fig 1. Alaska Board of Nursing Homepage
Unpacking the BON Website—Advisory OpinionsOnce on the Board of Nursing home screen, scroll down to the lower
section of the screen until you see the BON Advisory Opinion section and click on the link. You will see Advisory Opinions categorized into a variety of links. (see Fig. 2) Not all of the advisory opinions are online. Although the BON has been making Advisory Opinions for years, they have only been published online since 1990. Prior to that they are only to be found in the minutes of the BON meetings.
Fig. 2. Board of Nursing website
The top section of Advisory Opinions tends to be answers to scope of practice questions brought up by individuals or facilities and brought to the Board. They are thought to be significant enough that the opinion is published on the website in addition to being responded to with a letter. They are grouped under what type of licensee the question pertained too. The following are the Opinions from 2015 in the top section:
Licensed Practical NursesTopic: IV Administration by LPNsOpinion: BON approved the LPN intravenous course proposed by Chief Andrew Issac Health Center. LPNs who complete the course including competency checks can start IVs on patients over the age of 12. Interested Party: Chief Andrew Isaac Health Center Date: January 2015
Registered NursesTopic: Nitrous Oxide administration by RN for a Pediatric PatientOpinion: BON approves the educational program for RN administered Nitrous Oxide/Oxygen in the pediatric patient. The proposal is approved with an amendment noting administration of a maximum 70%. The intent of the motion is not to be restrictive based on either sign nor symptom of specific procedure.Interested Party: Fairbanks Memorial HospitalDate: January 2015/rev. April 2015/rev. July 2016
Topic: Nitrous Oxide for labor analgesiaOpinion: BON approves the expanded scope of practice for RNs to administer Nitrous Oxide for labor analgesia as follows: 1) the policy and procedures reflect that RN administering Nitrous Oxide holds a current ACLS certification.Interested Party: Fairbanks Memorial HospitalDate: April 2015
Advanced Nurse Practitioner (now APRN)Topic: Colonoscopy administration at ANMCOpinion: The Board approved the request by Lisa An, ANP to perform colonoscopies at ANMC based on her proposal and the mentoring of Claudia Christiansen, ANP who was previously approved by the Board. Interested Party: Lisa An, ANPDate: April 2015
The bottom section of the webpage on Advisory Opinions deals with topics that may be issues repeatedly brought to the Board, or, national issues in nursing that the Board feels should be addressed in a proactive manner. They are generally longer and include background information and references. They may be updated over the years such as the opinion on RN administration of sedating and anesthetic agents which has been written and revised in 2009, 2013 and again in 2015.
Although the top section of the webpage of opinions may be narrow responses to specialized scope of practice questions, the bottom section of Advisory Opinions are well worth reviewing by all nurses. The full text of the “Other Advisory Opinions” are too long to include here but the opinions that were either published or updated in 2015 were:
1. Registered Nurse administration of sedating and anesthetic agents.2. Telehealth for the Advanced Nurse Practitioner
If you have questions about the Advisory Opinions feel free to email the Executive Director of the Board of Nursing, Gail Bernth, APRN at [email protected].
September 2016 Alaska Nursing Today • Page 5
Lisa Jackson, DNP
The first cohort of Doctor of Nursing Practice (DNP) students at University of Alaska School of Nursing (UAA SON) are entering their final semester and will graduate in December, 2016. The DNP candidates will be the first to acknowledge how much the curriculum has expanded their view of advanced practice, health systems delivery, policy, and improving patient and health outcomes at a broader level. The students will present their evidence-based DNP project work at the Theta Omicron Chapter of Sigma Theta Tau Honor Society Conference “Using Evidence in Nursing Practice Everyday.” The conference takes place on October 15th, 2016, 8am to 5pm: at BP Center, in Anchorage, Alaska.
The School of Nursing graduate programs are poised for transition. The final Masters of Science, Family Nurse Practitioner (FNP) and Psychiatric Mental Health Nurse Practitioner (PMHNP) cohorts will begin fall 2017. The program will transition to Bachelors of Science in Nursing (BSN) to DNP degree in Fall 2018. Students applying for the Family Nurse Practitioner or Psychiatric Mental Health Nurse Practitioner specialty after December 1, 2017 will earn the DNP degree. The BSN to DNP is a full time three year program. Part time tracks will be offered.
The MS to DNP track is available to all Advanced Practice Registered Nurses who are licensed in the State of Alaska. The second DNP cohort will begin September, 2016. Applications are due to the SON and UAA by December 1 each year. Program information can be found at https://www.uaa.alaska.edu/academics/college-of-health/departments/school-of-nursing/future-students/index.cshtml. If you have additional questions, contact Dr. Lisa Jackson at [email protected].
UAA School of Nursing Update
LeMay Hupp, RN, Alaska Respond Training Coordinator
Upcoming HALE BOREALIS FORUMDon’t miss the three day HALE BOREALIS
FORUM to be held October 18, 19 and 20 at the Anchorage Hilton Hotel. This year’s theme, “Ingenuity and Integration for Better Outcomes,” will provide significant cross-disciplinary opportunities, evidence-based practice methods and current trends in regard to emergency preparedness and disaster response. Important information on the latest innovations will be included in over fifty sessions, many presented by national speakers. From Lessons Learned from the San Bernardino Attack, to Evacuation from the Ft. McMurray Fire in Canada, the Flint Water Crisis to the mass shooting at the college in Oregon, there is much for us to learn. For more information and registration go to: www.haleborealis.com.
Upcoming MOBILE DISPENSING EXERCISE, October 1
In a public health emergency, the health of the community may be impacted due to a large scale disease outbreak or intentional or accidental release of nerve agents, chemical
It’s Going to be a Busy Fall
By Barbara Berner, Director, School of Nursing, UAA and Chair, March of Dimes Nurse of the Year
Dating back to the polio era, nurses have played a key role in advancing the mission of the March of Dimes. In fact, 40,000 nurses volunteered to assist with the Salk polio vaccine field trials in 1954, the largest medical investigation of its kind ever conducted.
Today, nurses serve as volunteers, fund-raisers and advisors to the March of Dimes and are critical to the organization’s mission of improving the health of moms and babies.
This powerful connection will culminate in an evening of celebration and recognition on Friday, November 18, 2016 at the Dena’ina Convention Center in Anchorage when the March of Dimes Alaska honors these extraordinary caregivers for the 13th annual Nurse of the Year awards. Nurse
Nurses and the March of Dimes: A Critical Connection
of the Year is presented by the Children’s Hospital at Providence. Nurses will be presented awards in 15 different categories.
From the very youngest of patients in newborn intensive care units to the elderly in hospice, nurses protect our health, work to prevent injury, alleviate suffering and advocate for our care. Nurse of the Year is a way to say thank you and honor selflessness, dedication and passion for the profession of nursing.
The Nurse of the Year initiative supports the March of Dimes mission while recognizing exceptional nurses throughout the state, celebrating the profession and creating awareness of the strides made in this growing field. The purpose of the event is to raise public awareness of and interest in the diverse and rewarding careers available to nurses as well as to acknowledge the incredible contribution of nurses that occurs on a daily basis.
The Nurse of the Year event is an opportunity for March of Dimes, and the community, to publicly honor these wonderful caregivers who make such a difference in our lives. Have you been touched by the exceptional care of a nurse? Has a nurse co-worker inspired you? You can nominate a nurse! This is your opportunity to bring recognition to those very special unsung heroes. Simply access our quick and easy online application to nominate a nurse.
I am deeply honored to Chair the event this year. Along with a selection committee comprised of health care professionals, I will review the confidential nominations and select finalists in each category. Please join us as we acknowledge these amazing individuals who have touched the hearts and lives of so many.
More information is available online: marchofdimes.org/Alaska. For additional information, including tickets and honoring a nurse with a Tribute Gift, Contact Janie Odgers at (907) 276-4111 or [email protected].
agents, or biological pathogens. The Strategic National Stockpile (SNS) is a national repository of antibiotics, chemical antidotes, antitoxins, life-support medications and other lifesaving medical/surgical items designed to supplement and re-supply state and local public health agencies. The state will be assisting with setting up Points of Dispensing (PODS) for all to get medicines, including those that are home bound. Alaska Respond volunteers are being asked to assist in an exercise on Saturday, October 1, to volunteer in a current program that administers Influenza vaccine each fall. This will benefit the community and help us to fine tune our emergency operations plan for Mobile Dispensing in a crisis situation.
If you are an Alaska Respond Volunteer you will automatically receive the current training calendar, notices and other helpful information. For more information or to sign up, go to: www.akrepond.alaska.gov.
Anchorage & Wasilla, Alaska907-562-4540 [email protected]
Respect comes with the job when you’re a U.S. Air Force Nurse. The reason? You’ll be a commissioned officer with greater responsibilities. Of course, with greater responsibility comes greater opportunity to expand your areas of expertise or dig deeper into what you do now. Find out how the Air Force can make your career in nursing even more rewarding.
Airforce.com/healthcare800-588-5260
Page 6 • Alaska Nursing Today September 2016
Signing Day—July 6
Members of the Advanced Practice Registered Nurse Alliance gather around Gov. Bill Walker just after the signing of SB 53, a change in the nursing statutes that combines nurse practitioners, clinical nurse specialists, certified nurse midwives and certified registered nurse anesthetists under the title Advanced Practice Registered Nurse (APRN). The bill sponsored by Senator Cathy Giessel and lobbied for by the APRN Alliance was a four year endeavor
and included the Senator, APRN-A and the Board of Nursing. Pictured from left, APRNs’ Nan McGrath, Laura Sarcone, Tracey Weise, Ret. BON Executive Administrator Nancy Sanders, Carrie Doyle,
Gov. Bill Walker, Sen. Cathy Giessel, Lynn Hartz, Jessica Walsh, Andrea Hiles, Ex-BON member Beth Farnstrom, and Jeff Worrell.
ANPs, CRNAs > APRNs
Equity Now in Insurance Payments for Oral and IV Chemotherapy
Representatives of the American Cancer Society gather around Gov. Bill Walker after he signed into law an Act relating to insurance for “anti-cancer medication.” Prior to passage of SB 142, oncology patients
who might have been candidates for oral therapy were sometimes forced to use intravenous instead of oral chemotherapy due to preferential insurance coverage favoring intravenous forms of treatment. The bill ensures that both intravenous and orally administered chemotherapy are treated equitably by insurance companies as far as reimbursement. From left are sponsor of the
bill Senator Cathy Giessel, Gov. Bill Walker and Emily Nenon and Heather Aronno from the American Cancer Society.
Nurses in the News
Each year the American Academy of Nurse Practitioners honors an individual NP with the NP State Award for Excellence who has demonstrated excellence in NP clinical practice. This year Brittany Burglin, a nurse practitioner at the J. Michael Carroll Cancer Center in
Fairbanks was given the award. Ms. Burglin is known as a “Respected NP providing compassionate service by balancing the benefits and burdens of curative oncology therapies addressing patient’s personal goals.”
Mark Beck, MD was recognized with the 2016 AANP Advocate State Award for Excellence. The Advocate Award is given to an individual who has made a significant contribution toward increasing awareness and recognition of NPs. Dr. Beck practices at Diagnostic Health, Anchorage.
From left, Cindy Cooke, AANP President, Brittany Burglin, APRN, NP, Karen Fell, APRN, FNP, Alaska AANP Representative.
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September 2016 Alaska Nursing Today • Page 7
The University of Alaska conferred degrees upon the following students last August. The Alaska Professional Nurses Organization welcomes you to our profession. May you have long and rewarding careers!
Special honors were bestowed on these graduates:
Directors Award Awarded to the student with the highest GPA BS – Michelle Wilson
Spirit of Nursing Award Awarded by faculty vote for the student whom they feel demonstrates the spirit of caring, science, love of learning, and compassion.
BS – Hillary Olsen
Evidence-Based Practice Award The Evidence-Based Practice Award was established by the Alaska Professional Nurses Organization in 2013 to recognize a nursing student who integrates research-based evidence and clinical experience to achieve excellence in nursing practice.
MS – Monica Perez-VerdiaBS – Bryn Haebe and Jenelle Woodruff
Peer Award Awarded by the senior class to a fellow classmate who has completed their nursing studies while balancing the daily demands of life. Sponsored by the Alaska Nurses Association.
BS – Alexandra Burril
Congratulations Graduates 2016
Pictured are last spring’s FNP graduates. Thirteen more APRNs out into practice! Bottom from left. Deborah Forcht, Jessica Davis, Lisa Zatz, Casta Townsley, and Monica Perez-Verdia. Top from lt
Elizabeth Brown, Shawna Cooke, Debra Booysen, Audrey Frone, Stephanie Klein, Sara Lang, Adam Randall, Rhianne Christopherson, and Lisa Jackson faculty.
RN-BS GraduatesNikole AlexanderNicole BarkerAlina CushingTheresa OlannaRegina PierceDanette RobinsonKatie ShawRhoda Woodworth
BS GraduatesSarah ArmbrustAriel AustinDanielle AyersShannon BreskeAlexandra Burril*Pang Chang
Cassandra DahlMegan DavisNicole DeLongBryn Haebe*Caryn HaferMelissa HallJeanne HepperSamantha HolmquistNicole JensonChristina JohnsonValarie JosephShannon KimRachel LeamanStephen LoweCarley MattingleyKristina MattleStacey McCullyLindy Monagle
Nicole MooreHillary Olsen*Kyla PhillipsIrina PrinceMai ThaoEsther WeeKimberly WellsIndia WilliamsMichelle Wilson*Jenelle Woodruff*
MS GraduatesCarisa BattahMonica Perez-Verdia*Adam Randall
Are you a Registered Nurse looking for a reason to move to Seattle?
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Page 8 • Alaska Nursing Today September 2016
Con by Rachel White
Numbers of people infected with influenza can vary greatly from year to year. Over a period of 31 years, estimates of flu-associated deaths range from a low of 3,000 to a high of 49,000 individuals per year (CDC, 2015). It consists of multiple strains and virulence making it difficult to predict and treat. It is spread by droplets of those infected, and can be transmitted up to 48 hours prior to symptoms starting (CDC, 2015). For this reason many states and hospitals are starting to discuss mandatory vaccinations against the flu for healthcare workers.
Mandatory vaccination of healthcare workers to minimize transference is an unacceptable solution and unethical due to the inability to predict the strain, virulence, guaranteed protection, and limitation of long-term studies due to its constant changing nature.
Multiple factors contribute to the unethical concept and mandating that all healthcare personnel be required to vaccinate against the flu. First and foremost, flu viruses are constantly changing as they spread through the world, making it difficult to say with certainty that the vaccine will be covering the exact strain circulating in the United States (CDC, 2015). Vaccines are made based upon what researchers determine to be the most likely or suggested strain. “Flu viruses change constantly (called drift); they can change from one season to the next or they can even change within the course of one flu season. Because of these factors, there is always the possibility of a less than optimal match between circulating viruses and the viruses in the vaccine” (CDC, 2015, para. 19).
Secondly it is still possible to get the flu despite getting the flu vaccine (CDC, 2015). To mandate that healthcare workers be injected with a guesstimated substance that may still allow them to get the illness despite being vaccinated is unethical. “Unfortunately, some people can become infected with a flu virus the flu vaccine is designed to protect against, despite getting vaccinated” (CDC, 2015, para. 24). Protection from the virus varies widely based upon individuals overall health status and age as well as the similarity between the circulating strain and the ones within the vaccine (CDC, 2015).
There is plenty of valid research conducted currently to suggest a benefit to obtaining the flu vaccine, but not enough available to warrant
Health Policy Corner
Pro by Maura Walsh
Influenza (flu) is a contagious respiratory infection caused by influenza viruses that infect the respiratory tract. It can cause mild to severe illness; serious outcomes can include hospitalization or death. Anyone can get the flu, including people who are otherwise healthy, making influenza a major public health concern.
The Centers for Disease Control (CDC) recommends an annual influenza vaccination for most people 6 months and older as the single most effective means of preventing influenza. Influenza vaccines are safe and cannot cause the flu.
Numerous leaders in healthcare organizations support mandatory influenza vaccination for health care workers as an effective tool to protect staff, families and patients against influenza-related illness.1 The American Nurses Association (ANA) has taken a stand in support for mandatory influenza vaccines for health care workers (HCWs), ANA states, “registered nurses have an ethical responsibility to model the same health maintenance and health promotion measures they preach and research.”4
During the 2014-15 season, approximately 77% of HCWs reported receiving an influenza vaccination.3 This is below the Healthy People 2020 objective of 90%.4 Coverage was found to be highest in hospitals and lowest among HCWs in long-term care settings. In the absence of requirements, increased vaccination coverage was associated with employers offering vaccination onsite, free of charge, and offering vaccination for multiple days.3 The best way to prevent transmission of influenza to our patients is to get vaccinated against influenza. National Influenza Vaccination Week is December 6-12, 2016. Get vaccinated!
[I am a life-long Alaskan. I received my Bachelors of Nursing Science from the University of Alaska Anchorage and will graduate with my Masters of Nursing Science-FNP in May of 2018.]
1. Influenza Vaccination Honor Roll. Mandatory Influenza Vaccination for Healthcare Personnel. Available at: http://www.immunize.org/honor-roll/influenza-mandates/.
2. American Nurses Association Press Release, August 2015. Available at: http://www.nursingworld.org/FunctionalMenuCategories/MediaResources/PressReleases/ANA-Makes-New-Recommendation-All-Nurses-Should-Be-Immunized.html
3. Influenza Vaccination Coverage Among Health Care Personnel — United States, 2014-15 Influenza Season. Available at: ht t p://w w w.cdc .gov/m mw r/pr ev iew/mmwrhtml/mm6436a1.htm
4. Healthy People Objectives. Available at: http://www.healthypeople.gov/
Maura Walsh
Rachel White
Pro & Con of Mandatory Influenza Immunization of Health Care Workers in Alaska
a mandate safely. Healthcare workers should be allowed to make there own choices in regards to the risks versus the benefit. Mandating the injection of a substance into someone else’s body without having evidence based research to support the benefit or evidence to support true efficacy is not ethical or appropriate.
[My name is Rachel White and I have been a nurse for 7 years. I was born and raised in Las Vegas, Nevada where I graduated from nursing school in 2009. I moved up here 3 months later to accept a position at Providence in the ICU. I spent the first 5 years of my career as an ICU nurse before moving to the Emergency Dept. Being born in Nevada, I never experienced the outdoors and was awestruck by the beauty of Alaska. I found the love of my life on my Alaskan adventure and promptly married him. I now have a beautiful family of three daughters.]
ReferencesCenters for Disease Control and Prevention.
(2015). Key Facts About Seasonal Flu Vaccine. Retrieved December 3, 2015, from http://www.cdc.gov/flu/protect/keyfacts.htm
Centers for Disease Control and Prevention. (2015). What You Should Know for the 2015-2016 Influenza Season. Retrieved November 30, 2015, from http://www.cdc.gov/flu/about/season/flu-season-2015-2016.htm
Editor’s Notes:There are currently three hospitals in Alaska
with a mandatory influenza immunization policy.In the 2014-2015 flu season, the CDC reported
survey results of 1,914 health care personnel (HCP) and influenza vaccination.
• Overall, HCP in hospitals had the highest coverage of 90.4% and long-term care settings the lowest at 63.9%.
• Whether in hospitals or ambulatory care, nurses had the highest coverage between 90.8%-93.4%.
• The lowest coverage appeared to be in long term care, assistant/aides (59.8%).
• The take home message is that nurses in this survey appear to be doing great but nurses might want to lend a hand immunizing patients and aides in long term care facilities (see page 14 there is someone doing this!).
Source: Black, C. et al (2015) Influenza Vaccination
Coverage Among Health Care Personnel – Unites States, 2014 – 15 Influenza Season. MMWR. Morbidity and Mortality Weekly Report, September 18, 2015/64(36);993-999.
The School of Nursing at the University of Alaska is partnering with Alaska Nursing Today to present the selected works of some of our graduate students. These scholarly products are a result of a semester long partnership between the graduate student and a community stakeholder and must involve some aspect of Nursing Policy or the wider universe of Health Policy.
Thomas J. Hendrix, PhD RN teaches the graduate
UAA Health Policy course partners with the ANTHealth Policy course that facilitates this work and he has an open and ongoing invitation to any person or organization that has an interest in a policy matter to contact him to see if a future partnership with a student is a possibility. For the purposes of these projects, “policy” is defined in the broadest sense possible and includes, but is not limited to, organizational, inter-organizational, professional, regulatory and legislative at any level of government. The course requires 25-30 total hours of community work. According to Dr. Hendrix, “If you have an idea that fits these criteria, please let me know and let’s see if we can figure something out that works for all parties.” Dr. Hendrix can be reached at [email protected].
Dr. Hendrix, UAA Health
Policy Associate Professor
September 2016 Alaska Nursing Today • Page 9
By Becca Wachter, RN, PHN
For three hours last May, the Fairbanks Public Health Center’s meeting room transformed into a First Friday gallery. Families came to view local art, enjoy homemade snacks, and listen to live music. They had all come to enjoy the artwork depicting mothers holding babies to their chests while the babies, secure next to their moms, ate without concern of whatever else was going on in the photograph or painting around them. Perfectly natural, perfectly motherly —and most importantly, perfectly normal.
Becca Wachter
The event grew from an idea I had while reading a popular graphic novel where the heroes of the story had a newborn and were fugitives on the run. As the couple journeyed through outer space with limited resources, they breastfed their new baby. No one in the story mentioned breastfeeding; it was not a part of the story. The only reason the reader knew about it was the illustrations. Adult characters moved the plot and the baby was drawn sleeping, crying, and eating. I loved it. It was breastfeeding in a matter of fact way. No need to list health benefits – it just was.
More exciting—to a public health nurse—is that many of the people reading the comic may have never once thought about breastfeeding. Curious, I started to look through breastfeeding posters
Fairbanks Breastfeeding Coalition Art Exhibition
1st prize winner at the 2nd Annual Art Exhibition by Jill Saxton-Moody.
and art. I found multiple creative and beautiful works of art and graphic design, but most were public health posters or religious paintings. I did not find much art where breastfeeding simply was. If we want to promote breastfeeding as a normal everyday event, then we need to reflect that in our everyday surroundings, as part of what we observe normally and learn from daily life.
For our inaugural 2015 breastfeeding art and mingling event, seven artists contributed work and over 90 people attended the art opening. Individuals and the Fairbanks Hospital Foundation generously contributed donations that allowed us to offer 1st, 2nd, and People’s Choice prizes. Fairbanks Breastfeeding Coalition members donated cookies, vegetable platters, string cheese sticks, coffee and punch. Musicians playing fiddle, upright bass, guitar and
mandolin entertained the viewers; we even had a photographer to document the event. Families came and stayed, going through the displayed art multiple times, listening to music and talking with friends and families. The event was so successful that we wanted to make the arts show an annual event.
Building on the movement from the 2015 show we applied for and received the 2015 General Nursing Grant – Clinical/Community Project Grant from the Alaska Nurses Foundation. For the Second Annual Art Exhibition First Friday Event, we wanted to go further than we did the year before. We would have local judges come again to award prizes, but we would also have a group from the Alaska Breastfeeding coalition
choose one piece of artwork to develop an “Alaska Breastfeeds” poster.
The afternoon before the art show opening, the volunteer judges used professional criteria to judge artist’s skill, the composition, colors, and context of the piece. The group from the Alaska Breastfeeding coalition chose a piece that was fun, bright, and showed Alaskan mom’s breastfeeding as a part of everyday life. The decision on photographer’s Rachel Marney’s “Halftime” was unanimous.
Three months after choosing “Halftime,” we produced 50 posters, all 24” X 18.” We are currently distributing the posters to local healthcare providers, including all those providers I have been peppering with flyers for the past two years–WIC and public health offices around the state and to our local derby-girls team. Our hope is that this is the first of many more posters to come, both in the Fairbanks area, and around the state.
[When not curating art exhibitions, Ms. Wachter works at the Fairbanks Public Health Center. She can be reached at [email protected]]
Photographer Rachel Marney”s “Halftime” was chosen to produce posters for Fairbanks health
care providers.
Stay informed from coast to coast!• Access over 600 issues of official state nurses publications, to make your research easier.• Search job listings in all 50 states.• Stay up-to-date with events for nursing professionals.
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Page 10 • Alaska Nursing Today September 2016
Membership Magnet
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Call in at 907-743-4291The ANT depends on YOU. Membership fees of the Alaska Professional Nurses
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convenient way to join or make a contribution. Special rate for new grads.
Caduceus 12 step Recovery Meeting
(open only to health care professionals)
Thursday evenings, 5:45-6:45 pmAmazing Grace Lutheran Church,
Corner of O’Malley and Elmore, Anchorage
For free CE webinars on a variety of topics send your email address to
[email protected] with CNE on the subject line to receive a weekly notice.
Alaska Nursing Today
A small newsletter with big aspirations.
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The mission of the Alaska School Nurses Association is to optimize student health and academic success by supporting professional school nurses in Alaska.
Benefits include:• Continuing Education
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Every Child Deserves a School Nurse
Anchorage School District
• Health Treatment Nurses• School Nurses
• Substitute NursesApplicants must hold current Alaska RN licensure.
Prior acute care nursing experience is helpful.
Successful candidates will serve as valuable members of the Anchorage School District team!
Positions offer an attractive salary and benefit package. For a complete listing of the minimum
requirements and position responsibilities, please visit our website at www.asdk12.org.
To apply, please visit our website and submit an online Classified Job Application.
Anchorage School DistrictHuman Resource Department5530 E. Northern Lights BlvdAnchorage, Alaska 99504Phone 907-742-4116
www.asdk12.org
September 2016 Alaska Nursing Today • Page 11
a “high.”3 “In accordance with Federal law (21CFR 1306.17), office based opioid treatment, which provides medication on a prescribed weekly or monthly basis, is limited to buprenorphine.” Treatment length can be indefinite.5,6
3. Naltrexone/oral – an opioid antagonist that can be ordered by any clinician with prescriptive privileges. There is no physical dependence associated with Naltrexone and no recommended length of treatment. It is a recommended treatment used in preventing relapse in opioid use disorder but would not be helpful with withdrawal or craving symptoms as its antagonist function would only make symptoms worse.
The tricky part in MAT is where health policy meets insurance, reimbursement, and access. This can make a big difference as to whether a patient can even get treatment. For instance, only pre-certified physicians can order buprenorphine and until recently each physician could only have a workload of 100 patients (the number has since been increased to 275). In Alaska, that automatically limits out patient treatment in some rural areas where the only clinician might be a nurse practitioner.
In addition, in Alaska there are a limited number of treatment facilities, both rural and urban, according to Dr. Jay Butler, Chief Medical Officer and Director of the Division of Public Health. A lack of access to treatment puts the addict in the untenable position of going through withdrawal unassisted and without medication or continuing on the opiates they are addicted to. Dr. Butler continues to advocate at the Federal level for expansion of prescriptive authority of buprenorphine to APRNs and possibly PAs. Potentially that change would increase access to MAT for many addicts. Butler noted that nationally, there are over 900,000 clinicians with DEA numbers but there are only 34,000 who have the DEA X waiver to prescribe buprenorphine.
Local Treatment and ReferralIn addition to the out patient treatment
programs and clinical providers listed on the table below, are residential treatment programs which provide “medical detoxification” according to their website. The Ernie Turner Center in Anchorage is a 14 bed residential treatment facility that provides ‘detox’ and ongoing therapy for those with substance abuse to alcohol, opiates or stimulants according to a staff nurse at the Center. The Ernie Turner Center is the only residential facility in the Anchorage, Mat-Su area and has 50 people on its waitlist.7
The Ralph Perdue Center serves the Fairbanks area with 10 residential beds and 30 outpatient slots. The average residential stay is 45 days.
Alaska and the Opioid Epidemic continued from page 1
Alaska and the Opioid Epidemic continued on page 12
Source: State of Alaska, Division of Public Health
Alaska Responds Prescription Drug Monitoring Program
When the problem with increasing deaths due to prescription opioids was recognized, the federal government started funding programs to gather and monitor data on prescription of controlled drugs. There are now programs in 49 states. In Alaska, the program called the Prescription Drug Monitoring Program (PDMP) began in 2008. Based in the Alaska Board of Pharmacy, the controlled substance prescription database gathers information from in-state and out of state pharmacies on out-patient prescriptions for controlled substances for Alaskans. Data is not collected from hospitalized or ER patients.
The purpose of the PDMP is to improve patient care by providing prescribers and pharmacists the controlled substance history of their patients. Additional goals are to reduce drug diversion and assist in investigations when there is cause.8
Although the initial federal funding ended in 2013, a new federal grant has extended monies to run the program until 2021. In the most recent report to the legislature, 1,122, or 13.5% of prescribers were registered in the system for Alaska.8,9
In 2015, there were 202,141 patients who received prescriptions for Class 2 drugs, which would have included opioid drugs. Sixty-one persons in 2015 exceeded the 5/5 threshold in which they received a controlled substance from five different prescribers and five different pharmacies in a three month period. One person exceeded the 10/10 threshold.8 Until now, there has not been statutory authority for PDMP staff to send out unsolicited reports to prescribers that would alert them to possible diversion or abuse by individuals. Recent passage of SB 74 will allow notification of prescribers in cases of potential problems.
Use of the program by prescribers has been voluntary but appreciated by those who used it. Linda Lancasater, ANP, a recent registrant was impressed with the ease of access and use of the system. “There was no problem signing up. The Program Manager was really helpful and the site was user friendly.”
SB 74 ChangesSenate Bill 74, passed in 2016, is a lengthy
law dealing with Medicaid, telehealth and the PDMP. Changes in the law regarding the database bring it more into compliance with best practices recommendations in an ongoing effort to prevent diversion, substance abuse and substandard prescribing practices.
The following statute changes made by SB 74 have the potential to affect many nurses and APRN prescribers. In the Alaska Statutes book/online, these changes are found under Sec.21.AS 17.30.200 (a) through Sec.34.AS 17.30.200 (o):
1. Data on Class 5 drugs is no longer mandated but still requested.
2. Licensed pharmacies will now have to send in information on class 2-4 prescriptions on a weekly basis instead of monthly.
3. Prescribers with DEA authority have always had access to the database to look up information on their patients, they may now authorize “an agent or employee of the practitioner whom the practitioner has authorized to access the database on the practitioners’s behalf,….” the agent or employee must be licensed or registered under AS 08: Prior to this change, only the prescriber could access the database. Now, nurses in clinics may be asked to access the database. As the person will need to be licensed or registered, that could include LPNs, CNAs but will exclude unlicensed assistive personnel.
4. Though the database has some privacy protection, it is available to authorized public health personnel, law enforcement and Alaska tribal health organizations for aggregate data reports and individual criminal investigations. SB 74 expanded the list of those with access. Prescription information is purged from the database two years after the prescription is dispensed.
5. Any practitioner who prescribes controlled medication 2-4 “shall register with the database” in a procedure to be developed by the Board of Pharmacy. Failure to register could result in disciplinary action.
6. Prescribers are not obligated to check the PDMP when they are ordering non-controlled medication, nor are they liable.
7. Prescribers are obligated to check the PDMP and check the “patients prescription records before dispensing, prescribing, or ordering schedule 2 or 3 controlled substances under Federal law to the patient.” Exceptions to the law are patients in an inpatient setting, at the scene of an emergency, in an ambulance, in an emergency room, before, during or immediately after surgery, in a hospice or nursing home that has an in-house pharmacy: or a non-refillable prescription of a controlled substance in a quantity intended to last for not more than three days.
8. The Board of Pharmacy may now provide unsolicited information to a practitioner if a patient has received quantities of controlled substances in amounts or frequencies inconsistent with generally recognized standards of safe practice.
9. Fees for registration with the database will be set so that they are the same for all prescribers and pharmacists required to register.
Although the law has been passed, SB 74 will impact five Boards; the Medical Board, Board
Page 12 • Alaska Nursing Today September 2016
of Nursing, Board of Pharmacy, Board of Dental Examiners and the Board of Optometry. The boards will have to coordinate and make regulations for their licensees. It will probably be July 2017 before the process for registration is in place.10
Want to Register at the PDMP?Go to https://alaska.pmpaware.net/login
Help line 1-855-525-4767Email help [email protected]
SB 23Signed into law March of 2016, SB 23 is an Act
relating to immunity for prescribing, providing or administering overdose drugs. The drug referred to is naloxone, or Narcan, an opioid antagonist that antagonizes various opioid receptors. It is used to reverse opioid overdose.
Naloxone is a prescription drug but is not controlled. It is usually given SC or by nasal spray for fastest action.
Changes SB 23 has made:• The new law allows independent
dispensing of naloxone by pharmacists who have attended special training. This was unavailable before.
• Prescribers may now provide prescriptions not only to appropriate patients but to a family member, friend, caregiver, or other person who might need to administer the drug as long as they have been trained in administration. This may include nurses in residential treatment facilities or other treatment programs.
• The law now reads, a person is not liable for civil damages resulting from an act or omission in the emergency administration of the opioid overdose drug if they reasonably believe the person has had an overdose.
According to a New York Times article reprinted in the ADN, naloxone carries no health risk, cannot be abused and if given mistakenly to someone who has not overdosed on opioids, does no harm. Therefore if people who are at risk have the drug on hand, including family members and friends, it should help prevent deaths due to overdose.
Noting that lawmakers in all states but three have made naloxone easier to obtain, the article goes on to say,” Its near-universal availability reflects the relatively humane response to the opioid epidemic which is based largely in the nation’s white, middle-class suburbs and rural areas—a markedly
different response from previous, urban-based drug epidemics, which prompted a “war on drugs” that led to mass incarceration, particularly of blacks and Hispanics.”11
CE for NursesSCOPE of Pain: Safe and Competent Opioid Prescribing Education Designed for physicians, nurse practitioners, registered nurses, nurses, Scope of Pain will help you safely and competently manage your patients with chronic pain.2.00 CE for nurses (free) (funded by grants from pharmaceutical companies)www.mycme.com
American Academy of Nurse Practitioners AANPMembers of the AANP can access free CE on opioid management at the AANP website.www.aanp.org
State of Alaska DHSS Division of Public Healthhttp://dhss.alaska.gov/dph/Director/Pages/heroin-opioids/default.aspxThe Division of Public Health website has a link to Heroin and Opioids. Although this website does not provide contact hours it does have a wealth of information for nurses, families and patients. Clinicians can check the page regarding guidelines before prescribing an opiate. Nurses with concerns on a patient or needing to make a referral will find a link to list local treatment options.
Centers for Disease Control and Prevention Training and Education OnlineClinician outreach and communication activity (COCA)http://emergency.cdc.gov/coca/calls/COCA is providing a series of webinars on the recently published CDC Guidelines for prescribing opioids for chronic pain. The webinars provide free CE and will be archived. Participants must register. Multidisciplinary. Somewhat difficult to navigate at times.
SummaryAlaska and the opioid epidemic is a story of
good intentions regarding pain control gone awry, overuse of opioids resulting in deaths and eventual government and health care community recognition and response.
The resulting recognition of the lack of evidence of efficacy of treatment of chronic pain including opioids has led to initiation of studies. The increased rate of addiction has led to an emerging new concept of addiction in that use of opiates may have been a choice in the beginning but at some point it is no longer a choice. The brain has been
Alaska and the Opioid Epidemic continued from page 11 rewired and drug seeking is the main priority.12 Therefore, for treatment to work, clinicians and patients must view addiction as a chronic disease that will need lifelong management.
Alaska has made significant progress through passage of news laws such as SB 74 and SB 23 and has a robust public health education website. Further progress can be expected with the recommendations of the state Opioid Policy Task Force in the coming months.
References1. Dowell D, Haegerich TM, Chou R. CDC
Guideline for Prescribing Opioids for Chronic Pain — United States, 2016. MMWR Recomm Rep. ePub: 15 March 2016. DOI: http://dx.doi.org/10.15585/mmwr.rr6501e1er
2. Murthy, Vivek (2016, August). Fireside Chat. Discussion with Jay Butler presented at Alaska Wellness Summit – Conquering the Opioid Crisis, Mat-Su, AK.
3. Spencer, S. (2016, January). Buprenorphine for medication assisted treatment of opioid addiction. Lecture presented at the meeting of the Advanced Practice Registered Nurse Alliance, Anchorage, AK.
4. www.dpt.samhsa.gov (Substance abuse and mental health services administration.)
5. Kampan, Kyle and Jarvis, M. (2015). American Society of Addiction Medicine (ASAM) National Practice Guideline for the use of medications in the treatment of addiction involving opioid use. Journal Addiction Medicine, Vol 9 No 5, 1-10.
6. www.dhss.alaska.gov/dph/Director/Pages/heroin-opoids/reduce.aspx Alaska Division of Public Health accessed 8/8/16
7. Hollander, Z.(2016, August 5). Partners Southcentral, CITC expand services. Alaska Dispatch News, pp A1.
8. Alaska (State). 29th Alaska State Legislature. 2016 Alaska Prescription Drug Monitoring Program Report. From Alaska Board of Pharmacy. February 11, 2016. www.ak.gov
9. Butler, J.C (2016, January). Opioids: How did we get here? Where do we go now? Lecture presented at the meeting of the Advanced Practice Registered Nurse Alliance, Anchorage, AK.
10. Personal communication, Brian Howes, Program Manager, PDMP, 8/3/16.
11. Seelye, K (2016, July 28). Naloxone eases pain of heroin epidemic but not without consequences. New York Times, reprinted by Alaska Dispatch News, pp A6.
12. Personal communication. Jay Butler, MD. Dir. Division of Public Health, 8/8/16.
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American Nurses Association
Taking care of multiple patients, staying on top of paperwork, helping fellow nurses and other colleagues – an RN’s workday is busy and hectic. Even the best nurses occasionally commit errors of omission, which can have devastating effects on patient care and on nurses themselves.
To help understand and reduce these incidents of missed nursing care and to establish a foundation for support, the American Nurses Association has released Errors of Omission: How Missed Nursing Care Imperils Patients.
Based on 10 years of extensive research, Errors of Omission provides an in-depth review of the correlation between missed nursing care – standard, required nursing care that’s left undone – and adverse outcomes in both patient care and nursing staff retention.
Author Beatrice J. Kalisch, PhD, RN, FAAN, the Titus Professor at the University of Michigan in
Nursesbooks: Errors of Omission
APRNs, RNs looking forward to being part of solution to improve access to timely care
WASHINGTON, D.C. — Advanced practice registered nurses (APRNs) and other registered nurses (RNs) in the Veterans Health Administration (VHA) stand ready to be part of the solution to improve veterans’ access to timely, quality healthcare by working to their full practice authority as recommended by the Commission on Care in a report to the White House on July 5, said Juan Quintana, DNP, MHS, CRNA, president of the American Association of Nurse Anesthetists (AANA).
The commission, established as part of the Veterans Access, Choice, and Accountability Act of 2014, was charged with examining veterans’ access to VHA healthcare and determining how best to deliver healthcare to veterans during the next 20 years. The 308-page report was the culmination of an exhaustive 10-month assessment by the commission.
Speaking on behalf of a Nursing Coalition which endorses direct access to APRNs including Certified Nurse Practitioners (CNP), Certified Registered Nurse Anesthetists (CRNA), Certified Nurse Midwives (CNM), and Clinical Nurse Specialists (CNS), Quintana said that allowing all VA APRNs to practice to the full scope of their education and abilities without physician supervision would improve veterans’ access to essential healthcare by reducing long wait times for appointments and services.
The commission’s recommendation supports a Veterans Administration (VA) proposed rule to grant direct access to VA APRNs that was published in the Federal Register on May 25; comments on the rule are being accepted by the VA until July 25. With less than two weeks to go, more than 62,000 comments have been received from veterans, healthcare professionals, and the general public, mostly in favor of the rule.
“The evidence cannot be denied,” said Quintana. “The commission’s final report adds more data to the growing stack of evidence highlighting the need to allow all APRNs to have full practice authority as a major step toward increasing veterans’ access to quality healthcare.”
During its examination of veterans’
Nursing Coalition Praises Commission on Care Recommendations to Improve Veterans’ Healthcare
access to healthcare and how to best deliver healthcare services over the next two decades, the commission reviewed the results of the independent assessment of the VHA that was ordered by Congress in 2015; met with a broad range of stakeholders, including veterans and leaders of Veterans Service Organizations; made site visits to VHA facilities; and exchanged ideas with VA leaders and employees, members of Congress, and healthcare experts. Ten APRN and nursing groups provided an outline for the commission on the role and recommendations of APRNs to improve VHA healthcare delivery.
“The American Organization of Nursing Executives (AONE) applauds the Commission on Care for its support of full practice authority for advanced practice registered nurses in the VHA,” said Maureen Swick, RN, MSN, PhD, NEA-BC, AONE chief executive officer/American Hospital Association senior vice president, Nursing. “APRNs are a vital link to ensuring quality care is readily accessible for America’s veterans.”
“The clinical evidence and informed recommendations that patient care is improved by direct access to APRNs continue to grow,” said Cindy Cooke, DNP, FNP-C, FAANP, president of the American Association of Nurse Practitioners (AANP). “Veterans, the AANP, other APRN groups, the VA, and now an independent congressional commission on the VHA all agree that the VA’s highly-qualified APRNs, including 4,800 nurse practitioners who provide a wide range of healthcare services, are the right solution to ensuring veterans have access to timely, quality healthcare.”
American Nurses Association (ANA) Chief Executive Officer Marla Weston, PhD, RN, FAAN, who previously served in the VHA as program director in the Office of Nursing Services and then as deputy chief officer in the VA Workforce Management and Consulting Office, praised the commission’s recommendations on clinical operations.
“The commission’s recommendation that clinical operations should be enhanced through more effective use of health professionals – particularly optimizing use of advanced practice registered nurses – along with improved data
collection and management, is right on target,” said Weston. “The commission’s recommendation is consistent with the recommendations of the National Academy of Sciences to remove scope-of-practice barriers and allow the VA to fully utilize the skills of its APRNs to the full extent of their education, training, and certification.”
The American Association of Colleges of Nursing (AACN) commended the commission for recognizing that the way in which APRN students are educated must align with how they practice to achieve the best patient outcomes. “The Commission on Care should be applauded for its steadfast work to advance recommendations based on the evidence,” said Juliann Sebastian, PhD, RN, FAAN, chair of the AACN Board of Directors. “For our nation’s Veterans to receive the care they need, when they need it, we must look to the decades of data that show APRNs excel in providing high quality care when practice barriers are removed.”
The VA’s proposed policy to allow direct access to APRNs in order to improve veterans’ access to timely healthcare is supported by veterans groups such as AMVETS, Paralyzed Veterans of America, Military Officers Association of America, and Air Force Sergeants Association; AARP (whose membership includes 3.7 million veteran households); numerous healthcare professional organizations; and more than 80 Democratic and Republican members of Congress.
Comments on the proposed rule can be submitted at www.regulations.gov/document?D=VA-2016-VHA-0011-0001.
Coalition Members For more information about the coalition members, visit: American Association of Colleges of Nursing (www.aacn.nche.edu) American Association of Nurse Anesthetists (www.aana.com) American Association of Nurse Practitioners (www.aanp.org) American Nurses Association (www.nursingworld.org) American Organization of Nurse Executives (www.aone.org)
Ann Arbor, MI, and an ANA-Michigan member, has conducted extensive research on nursing care. Kalisch served as the 2013-14 Distinguished Nurse Scholar-in-Residence at the Institute of Medicine, which was supported by ANA, the American Academy of Nursing and the American Nurses Foundation.
The new book offers a wide array of resources to help readers learn about the different aspects of missed nursing care:
• Key areas of missed nursing care;• Consequences of not providing care;• Methods of studying missed care; and• The important roles of leadership,
management and teamwork in addressing and preventing missed nursing care.
Errors of Omission is essential to everyone in the nursing profession. Staff nurses and managers will find this book extremely valuable as they work to provide the highest standards of safe, quality care. Nursing students will gain a thorough understanding of the science and value of nursing care and the devastating effects of not providing it.
Learn how to prevent errors of omission to provide higher quality patient care. To order
Errors of Omission: How Missed Nursing Care Imperils Patients, visit http://www.NursesBooks.org.
We are in search of Experienced Registered Nurses who can make a significant contribution to their patients, co-workers, and professions by consistently providing the highest level of patient care and customer service.
•3-5yearsexperiencepreferred.•Supervisoryexperienceaplus!
If you are interested injoining our team call, fax,or email us at:
(907)564-2225 Phone(907)564-3886 Fax [email protected]
JOIN US IN ANCHORAGE AT
Page 14 • Alaska Nursing Today September 2016
Are You in the Know?Can’t stand typing in all those websites? Go to
www.akpno.org to download the online ANT and just hit the link.
Scholarships/Funding/Volunteer/Nominations
~ Serve our community and mentor UAA SON students ~
The Adult Immunization Program (formerly known as the Assisted Living Home Immunization Project) is now in its sixth year of providing seasonal influenza and pneumococcal vaccines to those most vulnerable in our community. Our program is looking for licensed and non-licensed individuals who are able to give immunizations and assist with paperwork. On October 1 and October 8 groups of volunteers travel to numerous homes in Anchorage and the Valley. For more information, contact Lisa Nash, project coordinator at [email protected] or 907-240-8905. Thank you for considering spending your time with us. _______________________________________________
Nurses Health Study Participants Needed: 8/4/16 One of the longest running studies of health is
expanding, and needs your help!The Harvard School of Public Health and
Brigham and Women’s Hospital are excited to announce that the Nurses’ Health Study, for the first time, is now accepting both male and female participants! Previous cohorts taught us much of what we currently know about how diet and lifestyle can affect risk of developing cancer and other serious health conditions, and you can help by completing simple web-based surveys every 6 months.
If you are 19 or older, and born after January 1st, 1965, JOIN the study! It only takes 40 minutes a year, and participation can be applied to your clinical ladder.
WHAT ELSE CAN YOU DO?Your encouragement will go a long way to
help explain how a small commitment to a study like this is of extraordinary value for promoting healthy living.
1. Encourage your colleagues to JOIN2. Like and Share us on Facebook, Twitter and
3. Forward this email to the nursing coordinator at work
4. Reach out to nurses in other ways. For example:• Through other nursing groups or
organizations• Posting information about the study at
your job• Local or national media contacts you
may have• If you are in a union, ask if they can
help spread the word
For more information, visit www.nhs3.org or email [email protected]_______________________________________________
AANP State Award for ExcellenceNominations for the prestigious 2017 AANP
State Award for Excellence will open on Aug. 8. The NP State Award for Excellence is given annually to an individual nurse practitioner in each state who has demonstrated excellence in NP clinical practice. The Advocate State Award for Excellence is given annually to an individual in each state who has made a significant contribution toward increasing awareness and acceptance of NPs. Examples of past recipients have been physicians, legislators, educators, etc. NPs are also eligible for the advocate award for non-clinical practice initiatives related to leadership, precepting, policy, politics, research, education, or community affairs. Now is the time start thinking about nominating a deserving NP or NP advocate (membership in AANP is not a requirement to nominate someone or to be nominated.) The Call for Nominations will be posted at aanp.org on Aug. 8. Deadline for nominations to be received by AANP is Oct. 10._______________________________________________
National Guidelines/Resources/Websites
Advisory Committee on Immunization Practices Recommended Immunization Schedules for Persons Aged 0 Through 18 Years—United States, 2016
Printable versions of the immunization schedule and patient friendly handouts can be found at the immunization schedule website.
(http://www.cdc.gov/vaccines/schedules/index.html)._______________________________________________
USPSTF recommends obesity screening for children ages 6 and up
A final recommendation from the US Preventive Services Task Force found insufficient evidence to recommend for or against pediatric high cholesterol screening among asymptomatic children or teenagers and noted the need for further research. The task force did recommend screening children ages 6 and older for obesity and making weight management counseling referrals as needed. [ANA smartbrief]_______________________________________________
Groups recommend improvements in pediatric trauma care
An American Academy of Pediatrics committee and other groups recommended guidelines for improving pediatric trauma care in the US, including having a pediatric trauma center or emergency department in every state that can treat severe injuries in children. The recommendations, published in the journal Pediatrics, also included having inclusive trauma systems in the US, earlier diagnosis of critical injuries, and continuing education for trauma and emergency clinicians. [ANA smartbrief 8/8/16]_______________________________________________
USPSTF recommends against routine asymptomatic herpes screening
The US Preventive Services Task Force issued a recommendation against routine screening for genital herpes among asymptomatic teens, adults and pregnant women. The task force notes that routine screening and early treatments are
unlikely to help those without any symptoms, as genital herpes is incurable, while experts recommend more awareness on signs and symptoms of the disease. [AANP Smartbrief 8/3/16]_______________________________________________
The 2016 U.S. Selected Practice Recommendations for Contraceptive Use (U.S. SPR) addresses common issues regarding initiation and use of specific contraceptive methods. The information in this report updates the 2013 U.S. SPR. Major updates include 1) revised recommendations for starting regular contraception after the use of emergency contraceptive pills and 2) new recommendations for the use of medications to ease insertion of intrauterine devices. These recommendations are a companion document to the CDC U.S. Medical Eligibility Criteria for Contraceptive Use, 2016. Google MMWR Vol 65, No. RR-4, July 29, 2016_______________________________________________
The 2016 U.S. Medical Eligibility Criteria for Contraceptive Use (U.S. MEC) comprises recommendations for the use of specific contraceptive methods by women and men who have certain characteristics or medical conditions. Notable updates since the 2010 U.S. MEC include the addition of recommendations for women with cystic fibrosis, women with multiple sclerosis, and women receiving certain psychotropic drugs or St. John’s wort; revisions to the recommendations for emergency contraception, including the addition of ulipristal acetate; and revisions to the recommendations for postpartum women; women who are breastfeeding; women with known dyslipidemias, migraine headaches, superficial venous disease, gestational trophoblastic disease, sexually transmitted diseases, and human immunodeficiency virus; and women who are receiving antiretroviral therapy. These recommendations are a companion document to the CDC U.S. Selected Practice Recommendations for Contraceptive Use, 2016. Google MMWR Vol 65, No. RR-3, July 29, 2016_______________________________________________
CDC expands Zika testing, protection guidelines for pregnancy
The CDC has revised its Zika virus prevention guidelines for pregnant women to warn of possible sexual transmission from an infected woman after female-to-male sexual transmission was documented. The CDC also revised testing guidance, including a recommendation that all pregnant women who may have been exposed to the virus undergo testing, even if they show no symptoms. [ANA Smartbrief 7/26/16]_______________________________________________
USPSTF recommendations provide more flexibility in colon cancer screening
The US Preventive Services Task Force has updated its guidelines for colon cancer screening to allow adults between the ages of 50 and 75 more freedom in choosing a screening method they are most comfortable with. Screening in older patients should be personalized based on general health and screening history, the task force said, and recommended screening intervals vary, depending on the method selected. [AANP SmartBrief 6/17/16]_______________________________________________
Alaska Guidelines/Resources/Websites
DHSS section of Chronic Disease Prevention and Health Promotion presents a monthly webinar series, 30 minutes each that can be participated in live or viewed in You Tube. go to www.dhss.alaska.gov/dph/Chronic/Pages/webinars/default.aspx to register or view previous webinars._______________________________________________
211 Alaska’s number to get connected to get answersFor your patients who need to find help in
Alaska, including disability services, counseling, senior services, health care and a variety of other social services. The line is open M-F 8:30-5:00. The website is www.alaska211.org_______________________________________________
43335 Kalifornsky Beach Road Suite 36
Soldotna, AK 99669Phone: 907.262.6331
Fax: 907.262.6351 Email: [email protected]
NURSES . . .
Is your back sore? Do your feet hurt? Are you ready to move to something less physically strenuous? Do you believe people are healthier and happier living in their own home and community?
Then FCS has the job for you! We are a nationally accredited agency serving individuals with disabilities for over 30 years. We are looking for the right RN who is organized and accurate with strong computer and writing skills.
If this sounds like you, let’s talk!
Resumes can be sent to [email protected] or to HR Department, Frontier Community Services,
43335 Kalifornsky Beach Road, Suite 36, Soldotna, AK 99669
September 2016 Alaska Nursing Today • Page 15
Events
Alaska State Board of NursingUpcoming Meetings
October 26-28, 2016 Fairbanks -agenda deadline October 5
January 18-20, 2017 Anchorage -agenda deadline December 28
The Alaska Board of Nursing has a list-serve that is used to send out the latest information about upcoming meetings, agenda items, regulations being considered, and other topics of interest to nurses, employers and the public. To sign up for this free service, go to www.nursing.alaska.gov Choose the “Subscribe to listserv” hyperlink on the homepage below the Board of Nursing Listserv Heading.
Inquiries regarding meetings and appearing on the agenda can be directed to:Gail Bernth, Executive Administrator Alaska State Board of Nursing550 West 7th Ave, Ste 1500, Anchorage, AK 99501Ph: 907-269-8160, fax 907-269-8196, email [email protected] attend by audio conference call 907-269-8161 for access number.
Continuing Education
ANT readers. Rather than typing in all those hyperlinks, you can also go to akpno.org and download the latest .pdf issue of the ANT and just click on any hyperlinks in the newsletter you are interested in.
Alaska Nurse Practitioner Association Fall Conference
September 22-24, 2016Captain Cook Hotel Anchorage
For information and registration www.alaskanp.com
AANP 2016 Specialty & Leadership Conference
September 22-25, 2016Hyatt Regency O’Hare Hotel
Rosemont, ILwww.aanp.org
Children’s Environmental Health Summit
October 5-6, Alaska Pacific UniversityMultidisciplinary
http://www.akaction.org/scholarships/
9th National Doctors of Nursing Practice Conference
Transforming Healthcare Through Collaboration
October 5-7, 2016Baltimore Marriott Inner Harbor at Camden Yards
www.doctorsofnursingpractice.org
Theta Omicron PresentsUsing Evidence in Nursing
Practice Every DayOctober 15, 2016
BP Center, 900 E. Benson, Anchorage, 7.5 CEwww.alaskanursingsociety.com
Hale Borealis ForumOctober 18-20, 2016
Hilton Anchorage Hotelwww.haleborealis.com
South Central AK Chapter of AACN Presents
Nicole Kupchick, RN, NM, CCNS, CCRN, PCCN
CCRN/PCCN Review CourseNov. 3-4, 2016
AK Native Tribal Health Consortium Office Building, Anchorage
contact Jana Shockman RN for info [email protected]
Alaska Public Health SummitJanuary 17-19, 2017
Hotel Captain Cook, Anchorage“The Changing Landscape of Public Health”
www.alaskapublichealth.org
AANP 2017 Health Policy Conference
February 26-28, 2017Hyatt Regency Washington on Capitol Hill
Washington, DCwww.aanp.org
AANP 2017 National Conference June 20-25, 2017
Pennsylvania Convention CenterPhiladelphia, PAwww.aanp.org
Up and Coming Event Calendar
State-of-the-art equipment • Education & professional supportExcellent pay with benefits • Outstanding lifestyle – work balance
Click on “Careers” to learn more about our available RN opportunities and to apply online.
Central Peninsula Hospital | 250 Hospital Place, Soldotna, Alaska 99669(907) 714-4785 • (907) 714-4674 Fax
Screening is required prior to employment. EOE
At Central Peninsula Hospital, you can have the job of your dreams AND enjoy an active lifestyle!
Join us on Facebook and Linkedin
Visit us online at www.cpgh.org
A journey that will take you farther.A culture that will bring you closer.
NuRsiNg OPPORtuNitiesServing the people of Southwestern Alaska, the Yukon-Kuskokwim Delta Regional Hospital is a 50-bed general acute care medical facility. Fully accredited by TJC, services Include adult med/surg, pediatrics, obstetrics, emergency room, as well as outpatient family medicine clinics, pharmacy, lab, and imaging. Consider the following RN openings:• Case Management • Inpatient• Charge • OB/GYN• Emergency Room • OR• EPSDT/Well Child • Outpatient Ambulatory Care• Infection Control
Requries at least 1 year of relevant experience, RN license in the stateof Alaska, and current BLS and ACLS.
LPN opportunities also available.For more information, please contact YKHC Recruitment at:[email protected] or 907-543-6065.YKHC exercises Federal Law (PL 93 638), which allows American Indian/Alaska Native preference in hiring for all positions.
Working Together to Achieve Excellent Health www.ykhcjobs.org
Improving the way clinicians diagnose, treat,
manage, and educate their patients.
The UW PTC provides classes that increase the knowledge and skills of healthcare providers in the area of sexual health.
Serving:AK, ID, MN, MT, ND, OR, SD, WA
For more information and to find training in your area
contact us [email protected]
Case Manager (Talkeetna & Willow) – The Sunshine Community Health Center is currently recruiting for a Case Manager, preferably with RN or comparable experience. Position participates as an integral member of the integrated primary and behavioral health care team. We offer competitive wages and a wide-ranging benefit package. Successful completion of a background check and pre-employment drug screening required.
Employment applications are available on our website at www.sunshineclinic.org. Please send a current resume, a letter of
interest and a completed employment application to:
Stephanie Stanley-Harrell, Human Resources ManagerSunshine Community Health Center | HC89 Box 8190, Talkeetna, AK 99676
Direct: (907) 733-9236 • Fax: (907) 733-1735mailto: [email protected]
ANP - FairbanksExceptional Benefits, Profit Sharing, PTO,
Tuition Assistance & More
Apply Online: www.TananaChiefs.org
Contact: Brad Clark, Medical Staff Recruiter(907) 452-8251 x3079
RN to BSN Online Program
• Liberal Credit Transfers
• Nationally Accredited
• No Thesis Required
• No Entrance Exams
MSN Online Program
No Campus Visits — Enroll Part or Full Time
BSN-LINC: 1-877-656-1483 or bsn-linc .wisconsin .eduMSN-LINC: 1-888-674-8942 or uwgb .edu/nursing/msn
Classes That Fit Your Schedule — Competitive Tuition
Page 16 • Alaska Nursing Today September 2016
Is Hiring NursesWe’re committed to being the best communityhospital in ALASKA. A history of service. A supportive community. We provide quality health care and health promotion for the people of JUNEAU and communities of Southeast ALASKA.
We have openings available in many areas:• Nursing Administration• Surgical Services• Behavioral Health• Obstetrics• Critical Care• Emergency• Medical and Surgical
GENEROUS RELOCATION PACKAGE –INCLUDES TEMPORARY HOUSING!
AMAZING BENEFITS CAN BE FOUND HERE: https://www.bartletthospital.org/careers/human-resources.aspx
Bartlett Regional Hospital
3260 Hospital DriveJuneau, AK 99801
www.bartletthospital.org
Join the Samuel Simmonds Memorial HospitalTeam in Barrow, Alaska
Samuel Simmonds Memorial Hospital (SSMH) is a facility unlike most others; it is located in the northernmost city of the United States and serves a population that spans across a region larger than the state of Washington. Serving the North Slope, a region that is colored by the heritage of the Iñupiat people, SSMH works to preserve the health of the region as well as the culture.
By joining SSMH, you’ll be embarking on an adventurous journey as enriching as it is rewarding. Here you’ll have the unique opportunity to provide health care to a vibrant community ready to share its culture and heritage. More than a once in a lifetime opportunity, you’ll provide care in a small community environment, and partner with a familial, professional staff. It’s an experience you won’t forget. Join us today.
Direct care positions qualify for the IHS tuition reimbursement of up to $20,000 per year. For more information on this loan repayment: www.ihs.gov
We are recruiting for the following Nursing positions:
• Emergency Department• Inpatient Med/Surg RN
• Case Managers• Primary Care Nursing
• Clinical Mentor/House Supervisor• LDRP/OB
Contact Us:E-mail: [email protected]: (907) 852-9204Fax: (907) 852-3365Mail: P.O. Box 29 Barrow, AK 99723Visit: www.arcticslope.orgTo speak with someone in Nursing Leadership feel free to call 907-852-9256.
