The Pulse

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Princeton, MN55371

President’s Introduction

Page 2

Who’s Who at MNA?Page 7

APRN NewsPage 6

Ignite the Promise: 1st Global Advocate Summit on Breast CancerKim Powell, APRN, ACNP-BC

Budapest, Hungary, a beautiful European city straddling the Danube River, was host city for the 1st Global Advocate Summit on Breast Cancer, sponsored by Susan G. Komen for the Cure held in September 2007. I was fortunate to have been selected as one of 25 US Delegates to participate in this historic meeting. Prior to the conference, I attended a luncheon at the White House hosted by First Lady Laura Bush who is the Komen Global Summit Co-Chair, and longtime supporter of the Komen organization.

Just a short 25 years ago, the Susan G. Komen Breast Cancer Foundation was established by Nancy G. Brinker in memory of her sister, Susie Komen, who died from breast cancer at the age of 36. Breast cancer was a common occurrence at the time, yet was not spoken of outside the whispered tones between women and their health care providers. Once diagnosed, it was difficult for women to locate support services and the prognosis was often grim. During this 25 year period the Komen Foundation provided more than $1 billion to empower people, ensure quality care for all and energize science to find the cures to this life-threatening disease. The successes began to multiply. 25 years ago, the five year survival rate was only 74 percent even when breast cancer was diagnosed before it spread beyond the breast. Today, it is 98 percent. Nationally, nearly 75 percent of women over the age of 40 now receive regular mammograms compared to just 30 percent in 1982.

Komen’s sensitivity to and awareness of the global impact of breast cancer next led them to develop the Global Summit, bringing breast health advocates together to share successes and stimulate problem solving while acknowledging cultural differences. It was an invitation to take the many small steps of success towards the eradication of breast cancer and add them together… and step that much closer to a cure.

While we have enjoyed successes in the US, the worldwide snapshot of breast cancer is chilling. In 2008, more than one million breast cancer cases will be diagnosed and 370,000 deaths will be attributed to breast cancer. In many nations, women present with the largely incurable and often fatal stage 3 and 4 breast cancers. In countries where poverty, famine and war exist, breast cancer diagnosis and treatment have a low priority for attention. In governments struggling with provision of basic necessities, health issues, particularly those of women, are brushed aside. In many Middle Eastern countries, cultural mores prohibit women from seeing physicians without their husband’s permission.

In developing countries the diagnosis of breast cancer is seen as a declaration of imminent death and in some areas it assigns a social stigma to the family of breast cancer victims. Unthinkably, these women and their families are seen as unclean and shunned by others. And so, women often hide their symptoms out of fear of being ostracized or causing shame to their families, delaying diagnosis until the chance for treatment and cure are extremely limited.

Dr. Mohammed Shaalen, surgeon and Chairman of the Breast Cancer Foundation of Egypt, noted that more than 60% of his patients present with Stage 3 or 4 breast cancers at their

T H E O F F I C I A L

P U B L I C A T I O N

O F T H E M O N T A N A

N U R S E S A S S O C I A T I O N

VOL. 45 NO. 1

JANUARY–MARCH 2008

I N S I D E

We’ve Moved!!!It was quite a feat but MNA has moved into its new facility

at 20 Old Montana State Highway in Montana City. This new location is just 5 miles south of Helena on Interstate 15.

Two weeks prior to the move Maxine Ferguson along with staff worked tirelessly to pack, dispose, shred and organize boxes of materials and furnishings needing to be moved to our new location. Thank you, Maxine! By 8:30 am on December 13th the moving van arrived at the Old Lodge Building and loaded as much as possible for delivery later that day to our new location, just 5 miles south of Helena on Interstate 15. December 14th the movers completed the job and got the majority of our belongings in near proximity to where they belonged. There were boxes and furnishings everywhere but we are happy to report we are now settled in and loving our new location.

The new facility boasts a large reception area, 7 office spaces, large conference room, spacious classroom, lovely break area, three restrooms and a basement storage area. To form this new location an extension was built onto an existing building that previously housed a taxidermy business.

The new addition is considered a “green” building with numerous windows for solar energy and minimal lighting needed. Walls designed to absorb and distribute heat for energy efficiency along with a water collection system are also

features at the new site. Our new classroom will not only enable MNA to sponsor future on-site continuing education throughout the year but also as rental space for other interested parties in the area to meet. MNA is extremely proud of its new facility. If you are ever in the neighborhood please don’t hesitate to stop in and see our new location.

(continued on page 11)

MNA board member Kim Powell, right, and Becky Morris, left, enjoy a moment with First Lady Laura Bush following Mrs. Bush’s remarks at the pre-Global Summit White House Luncheon in June 2007. Mrs. Bush is the Komen Global Summit Co-Chair. She is a long time advocate of breast cancer awareness with personal ties in that her mother is a breast cancer survivor. Becky Morris is President of the Women’s Cancer Advocacy Network in Glen Allen, Virginia and a breast cancer survivor. Kim Powell is the current President of the Montana Komen Chapter. Her term will expire in May. She is also a breast cancer survivor.

(continued on page 2)

From historic downtown Helena . . . to new age rural Montana City.

Page 2—Montana Nurses Association Pulse—January, February, March 2008

The PulseOfficial Publication ofthe Montana Nurses

Association

We’ve Moved(continued from page 1)

New Building Front HallwayNew Building Entrance Reception

New Building Break Room

CONTACTING MNAMontana Nurses Association

20 Old Montana State HighwayClancy, MT 59634

Phone (406) 442-6710Fax (406) 442-1841

Email: info@mtnurses.orgWebsite: www.mtnurses.org

Office Hours: 8:30 a.m.–4:30 p.m. Monday through Friday

WHO WE ARE

The Montana Nurses Association is a professional association for registered nurses, including advanced practice

registered nurses, students, and retired nurses in Montana. MNA provides collective bargaining services, continuing education, and professional networking opportunities. MNA advocates on behalf of nurses before the Montana

legislature, the Montana Board of Nursing, and other public policy bodies.

MISSION STATEMENT

The Montana Nurses Association promotes professional nursing practice, standards and education; represents

professional nurses; and provides nursing leadership in promoting high quality health care.

MNA

Board Executive Committee:President Tina Hedin, RNPresident-Elect VacantSecretary/Treasurer Lori Chovanak, BSN, RNC

Board of Directors:Vicky Rae Byrd, RNBrenda Donaldson, RN, BSNGwyn Palchak, RNC, BSNMary Pappas, RN, EdDKim Powell, MS, APRNBarb Prescott, RN, FNP-BC, DNPMae Rittal, RNRebecca Sturdevant, MSN, APRN

Editor: Robert AllenAssistant Editor: Jolene DevineEditorial Board:Lynn Hebert, RN, Chair–Sun RiverMary Pappas, RN, EdD–HavreKim Powell, MSN, RN–MissoulaBarbara Prescott, RN, FNP-BC, DNP–BozemanMae Rittal, RN–Sidney

MNA Staff:Robert Allen, Executive DirectorBill Smith, Labor Relations SpecialistJolene Devine, Projects Manager

Questions about your nursing license? Contact the Montana Board of Nursing at: www.nurse.mt.gov

WRITER’S GUIDELINES:

Any author is welcome to submit an article related to nursing or Montana nurses in The Pulse. Please contact the Assistant Editor at jolene@mtnurses.org.

PUBLISHER INFORMATION & AD RATES

Circulation 16,000 to every Registered Nurse, Licensed Practical Nurse & Nursing Student in Montana. The Pulse is published 4 times annually by the Arthur L. Davis Agency for the Montana Nurses Association, 104 Broadway, Suite G-2, Helena, MT 59601.

Acceptance of advertising does not imply endorsement or approval by the Montana Nurses Association 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. MNA and Arthur L. Davis Publishing Agency 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 MNA or those of the national or local associations.

Advertising Rates: Contact Arthur L. Davis Agency, 517 Washington St., P.O. Box 216, Cedar Falls, IA 50613, 800-626-4081. MNA and the Arthur L. Davis Agency 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.

Material is copyrighted 2005 by the Montana Nurses Association and may not be reprinted without written permission from MNA.

January, February, March 2008—Montana Nurses Association Pulse— Page 3

Tina Hedin, RN

Allow me to introduce myself. I am Tina Hedin and I was born and raised in Billings. I attended MSU-Northern when it was still Northern Montana College. I started my nursing career in White Sulphur Springs. If the opportunity presents itself, rural nursing is certainly an experience worth giving a try. There was one RN on duty when I worked there. We dealt with just about everything, the hospital, the Emergency Room, obstetrics, and even did a little surgery. I volunteered on the Meagher County Ambulance where I got the “taste” of pre-hospital care. I spent almost 4 years in White Sulphur, starting off as a staff nurse and advanced to Director of Nurses.

In 1987 I moved back to Billings and began my 20-year (and counting) career in Emergency Nursing at Billings Clinic. Through this experience I realized a special relationship between ED nurses and law enforcement. Fortunately about the same time the emergence of a new field of nursing was on the horizon–that field being Forensic Nursing.

I was one of a handful of people who saw the need to develop a Sexual Assault Nurse Examiner (SANE) program in Billings. This program exposed me to yet another world of nursing. The development of the SANE program required we talk with our local MNA unit to work outside the contract. We petitioned the Board of Nursing to allow specially trained RNs to perform speculum exams. In time, I was asked to testify at the State Legislature about the importance of having an anonymous report option available to the sexual assault patient.

It was during those experiences that I realized the need for nurses to have a strong voice and become active in their professional organizations. I believe that MNA is the strongest voice nurses have in Montana. I assumed for many years that “someone” would take care of nurses at all levels, that “someone” was making the right, safe choices for patient. I realized then that “someone” needs to be me–the nurse.

On a personal note, I am the proud “mom” of two very pampered Keeshonds–Kodi and Rascal. I am blessed with living in the same city as my entire family. My escape is taking pictures–I love to take wildlife and landscape pictures. I also love to travel. My most exciting trip so far has been a trip to Africa. My “five-year travel plan” includes a Mediterranean Cruise, a Polar bear expedition, and whale watching in Cabo.

I am excitedly nervous about the next two years. I look forward to serving as your president. I welcome any thoughts and input from each of you on how MNA can be your voice. My challenge to you is to become aware and then involved in your professional nurses organization.

Linda Henderson, 2006-2007 MNA President is awarded her President’s pin by Robert Allen, MNA Executive Director.

Dues Deductibility for Income Tax Reporting

Under the Omnibus Budget Reconciliation Act of 1993, that portion of your membership dues used by the Montana Nurses Association and the American Nurses Association for lobbying expenses is not deductible as an ordinary and necessary business expense. Montana Nurses Association reasonably estimates that the non-deductible portion of dues for the 2007 tax year is 18%.

Remember that membership dues are not deductible as a charitable expense, but rather they may be deductible as a business expense if you itemize. If you have questions, please feel free to contact the MNA office at (406) 442-6710.

Celebrate National Nurses’ Week May 6-12, 2008“Nurses—Making a Difference Every Day” is the theme for

the 2008 National Nurses Week. National Nurses Week begins May 6 and ends on May 12, Florence Nightingale’s birthday. The week is set aside to celebrate and honor the dedication, commitment and daily efforts of nurses in Montana and nationwide. Montana Nurses Association promotes the nursing profession at the state, district and local levels. Each conducts celebrations on these dates to recognize the contribution that nurses and nursing makes to the community.

How will you celebrate? What activities are your facilities planning? Please contact the MNA office with information on any events celebrating National Nurses’ Week in your community.

President’s Introduction

Tina Hedin

Page 4—Montana Nurses Association Pulse—January, February, March 2008

An Essay: Whose Truth is Truth?

Barbara Prescott, RN, FNP-BC, DNP

In our secular society it is difficult to reconcile the world views of religion and science. Is there a relationship between science and religion? How do they compliment and detract from one another? Both disciplines have strong effects on a nation’s culture. How do these cultural effects affect the nature of science and the nature of religion?

Science and religion have been influencing society since the beginning of recorded history. The bible talks about controlled experiments in 1 Kings 18: 19-40 where the prophet Elijah conducted a controlled trial designed to show the Israelites the power of the true God. Elijah challenged 450 prophets of Baal to offer sacrifice to their god; and he would do the same to his God. The pre-specified end point in the experiment was “and the God which answers by fire, let him be God.” After hours of observing spirited but fruitless pleas to Baal, Elijah called on God and the rest is history. And the bible talks about the Magi (wise men or astronomers), scientists visiting the Christ child making the funds for the flight into Egypt available.

Aristotle used observation and experimentation to study humans and their responses. He recorded the positive affects of willow bark as a medicinal intervention (aspirin). The Arab world took Greek learning in the area of science and expanded it. They elevated observation and experimentation to an art form and integrated observation and experimentation into the discipline of science long before Roger Bacon, known as the originator of the experimental method, was born.

The knowledge developed through the disciplines of science and religion grew through the ages. In the beginning, religion grew faster than science. Religion was able to give society an answer to the questions of why and who. By the Renaissance, religion ruled society. The western civilization embraced scientific inquiry but society was controlled by the church. Since I am interested in American science, I decided to look at the history of

science from a western or European perspective.Galileo, one of the most notorious scientists

in western history, made enormous strides in mechanics and astronomy. When his observations and experiments proved that the earth was round and not the center of the universe, the great inquisition occurred. Though many church scholars believed the findings of Galileo, the dogmatic leaders of the church decided that this knowledge would be “bad” for the people and they had Galileo put under house arrest.

The church controlled the amount of knowledge shared with society to better control the culture and the people. However, Galileo continued to write and study. Galileo’s knowledge was shared with intellectuals from many countries and disseminated regardless of the church’s attempt at censure. As knowledge grew both science and religion grew with science discovering the how and religion looking into the why.

Today, the differences between scientific and religious language create barriers for both science and religion that prevent them from helping society and humanity in a complementary way. Science and religion share the view that each person has value and dignity. Science and religion differ, however, principally in that science seeks to answer “how” and religion continues to seek to answer “why” and “who.” Unfortunately, scientists and religionists often embrace their world view so strongly that they fail to appreciate alternative views and identify the limitations of their perspectives. This leads to tunnel vision.

Let us view a scene from nature. Considering the religious perspective and the scientific perspective, which perspective would you as an individual and a scientist use to describe this scene first? Looking at the picture what religious concepts jump out? Which scientific concepts? Can the two ways of viewing the scene complement each other giving a more complete sense of the whole of the scene? Both science and religion work for the benefit of the human race. Should they not look at the person and nature holistically and complement each other?

A strictly scientific approach, especially with regards to nursing, overlooks important considerations–life’s meaning and purpose, an individual’s quest for a relationship with his/her maker, and the gift of hope. On the other hand, if a religious sect claims absolute truth through blind faith then their dogma stifles scientific inquiry

Science and Religion

Barb Prescott

and the utilization of research that enhances and benefits society.

Today scientific knowledge is growing exponentially. In the west, science and technology are out stripping religion, ethics, and legal thought. Controversies abound while society is trying to come to grips with ever accelerating change. The issue of whose truth is truth has taken on a more urgent status for zealots in their perspective fields. The primary targets or audiences for their issue starts with communities and constituents and moves out to society as a whole. However, the audience that is primarily manipulated by the agenda of the dogmatic scientists and the religionists are the media, politicians, and then ultimately society in general. The agenda of both science and religion is promoted or detracted through media coverage of the specific issues. Once the media stirs up public interest, politicians and public policy can be affected.

In order for nurses to be aware of the issues that affect the healthcare of their patients, they should consider the following questions:

What are some of the healthcare current issues being discussed in the media that are ripe for the debate between scientists and religionists?

What are some strategies that can empower patients to make informed decisions regarding the issues?

Is it really important to determine whose truth is truth? Can both religious and scientific perspectives be true within the patient’s world view?

January, February, March 2008—Montana Nurses Association Pulse— Page 5

Helena, MT

The 14th annual Race for the Cure will be held in Helena on May 17th. Breast cancer survivors, their families, friends and supporters will gather by the State Capitol to participate in their choice of a 5K or 1 mile race or a leisurely walk of 1 mile.

The goal for this year’s event is $150,000. Seventy-five percent of the funds raised remain in state providing breast health education and breast cancer screening. Each year, Komen Montana distributes these funds throughout the State to agencies who provide services for Montana women. The remaining 25% is sent to the “large grant” fund at Komen National Headquarters where it is pooled with contributions from 122 other Komen Affiliates and supports the Komen Award and Research Grant Program which funds groundbreaking breast cancer research, meritorious awards and educational and scientific programs around the world. Susan G. Komen for the Cure has been named the top-rated charity by Charity Navigator, America’s largest independent evaluator of charities.

As a sponsor of the annual event, Montana Nurses Association invites all nurses to join together to form the first-ever Montana Nurses for the Cure team. Nurses interface with breast cancer on many planes–as breast cancer survivors,

Susan G. Komen Race for the Cure Seeks Nurse Leaders

In 2003, MNA Executive Director Sami Butler inaugurated the “Nurses for the Cure” program to support the fight against breast cancer and raise funds for the Montana Affiliate of Susan G. Komen for the Cure. The 2008 Race for the Cure Co-Chair, Annette Cade RN, is looking for a Montana nurse or nurses to coordinate & encourage Montana nurses to join the “Nurses for the Cure” program. It’s the experience of a lifetime–add your “small-step” with those around the world! Contact the Montana Affiliate office at 406-495-9337 to volunteer.

Race For the CureRace For The Cure–May 17, 2008

Dorothy Schweer RN, Billings, Anna Brewer RN, Billings, and Sandy Davies RN, Missoula (left to right) ready themselves for the Race for the Cure.

providers of care for breast cancer patients, and as friends and family of those affected by this disease. MNA would like to challenge each of you to come forward and participate in this worthy event. Show your support for your peers and those we serve. Issue a challenge to other nursing groups to see who can raise the most money! Student nurses vs. Nursing Faculty, hospital vs. hospital, office vs. office… think of the possibilities and the fun this healthy challenge will bring to your team!

Montana Nurses who answer the challenge can sign up on-line for the Nurses for the Cure Team beginning February 20, 2008. Can’t make it to Helena on the 17th of May? No problem! Simply note that you wish to be a “Spirit Runner” for the event. Your Montana peers will carry your name in their walk around the course and your registration fee will contribute to raising funds to find a cure for this dreaded disease. And remember: your contributions go directly to Montana women or national research, not to corporate costs.

You will enjoy the spirit, the joy, and the very touching atmosphere of the event. Dust off those running/walking shoes and join us in Helena on May 17th! Go to www.komenmontana.org and sign up for the “Nurses for the Cure” team or form your own unique team! For assistance, please contact the Komen Montana office at 406-495-9337.

Kim Powell, APRN, ACNP-BC

Montana is not immune to breast cancer concerns. In fact, breast cancer is the most common cancer among women in this state. The incidence of breast cancer more than doubled between 1979 and 2003 with 800 breast cancers now diagnosed annually. Some of the increase in diagnosis may be due to the success in developing screening programs. According to the October 2006 Quarterly Surveillance Report on Breast Cancer in Montana, an annual random telephone interview survey of representative Montana residents reported that 28% of women age 40 and older reported NOT having a mammogram in the past two years, compared to 42% in 1990.

And so, we must “begin-to-begin”... just as our peers around the globe begin to develop programs to educate women and government officials about breast cancer in order to address the gaps in knowledge, access and treatment. What can you do to encourage women to have routine breast cancer screening in order to diagnose breast cancer in its earliest, highly-curable stage?

1. TEACH—Nurses are educators. Use your knowledge and health care connections to teach others about the importance of breast cancer screening. Dispel the myths. Clarify the screening recommendations.

2. KNOW THE GUIDELINES—The American Cancer Society recommends that women age 40 and older have annual mammograms. Clinical breast exams, performed by a licensed health care provider, should be done annually. Self breast exam should be performed a minimum of one time monthly.

3. REFER—The reasons why women do not follow recommended guidelines are varied: lack of education about the importance of screening, lack of accessible facilities and health care coverage rank high. The Montana Breast and Cervical Health Program (MBCHP) is a federally funded screening program for low-income, minority and medically underserved woman. Women who meet program guidelines are eligible for screening, diagnosis and, in some cases, treatment support through this program. Contact MBCHP at 406-444-0063. In addition, many facilities offer programs for reduced or no cost screening through the generosity of donors or grants offered by the Montana Komen Affiliate. Nurses know how to connect,

Breast Cancer: What Nurses Can Do in Montanaconsult and refer appropriately. Please offer your expertise to those in need.

4. START WITH YOU—If you are 40 or older, have you had a mammogram? Have you had a clinical breast exam? Do you routinely perform breast self exam? Breast cancer strikes 1 in every 8 women nationwide. Nurses are not exempt.

5. ENCOURAGE OTHERS—Women need to be reminded how important their health is–not only for themselves, but for those who depend on them. Question your family, friends, and co-workers; write it in an email; wear a pink ribbon... your reminders may save a life.

6. PARTICIPATE—There are many opportunities to share your skills. Volunteer to teach in your community. Donate the cost of a mammogram to your local mammography center. Organize a team for the Komen Race for the Cure. Volunteer with the American Cancer Society. The opportunities are endless.

Breast Cancer Websites of InterestMontana Breast and Cervical Health Program http://www.dphhs.mt.gov/PHSD/cancer-control/

Breast&Cerv-index.shtmlSusan G Komen Breast Cancer Foundation–

www.komen.orgKomen Montana Affiliate–www.komenmontana.orgMontana Nurses for the Cure http://www.mtrace4thecure.org/events/race/

nurses.htmMore about the Global Advocate Summit http://cms.komen.org/komen/NewsEvents/

GlobalAdvocateSummit/index.htmAmerican Cancer Society–www.cancer.orgDirectory of Organizations Fighting Breast

Cancer (US Dept of Health and Human Services)

http://www.4women.gov/napbc/catalog.wci/napbc/orglist.htm

This is a short list. You can explore more by searching on Breast Cancer, Breast Cancer Organizations or any combination of search words you might choose.

Page 6—Montana Nurses Association Pulse—January, February, March 2008

APRNs were “practicing medicine,” were dismissed. Despite that success, the APRNs were unable to reach a satisfactory agreement with the hospital and radiologist. Vicki Thuesen and Shari Healy ultimately filed a lawsuit for restraint of trade against the radiologist and hospital.

The APRNs have received strong support from patients and community members, nurses across the state of Montana, and APRNs across the country. The Montana Nurses Association has committed funds to file an amicus brief in support of their case and numerous individuals have contributed funds to help cover legal costs. Action on the lawsuit continues and it is anticipated that the case could go to court in early 2008.

The impact of the final decision in the lawsuit could have wide-range implications for APRN practice across the country. Hailed as Nurse Practitioners of the Year in October 2007, Healy and Thuesen remain committed to seeing the process

Kim Powell, APRN, ACNP-BC

Montana Advanced Practice Registered Nurses (APRNs) have enjoyed a broad and independent scope of practice since the inception of APRN enabling legislation. Through strong standards for advanced practice education, certification, and maintenance of competency, Montana APRNs have experienced tremendous growth in practice opportunities and respect from patients and practitioners.

Vicki Thuesen, APRN, FNP, WHNP, and Shari Healy, APRN, FNP, developed the Gold Street Clinic in Butte, Montana about four years ago and enjoyed a robust primary care practice working collaboratively with other health care practitioners in the community. Without provocation, the APRNs received notice from the physician director of radiology/pathology at St. James Hospital that he would no longer accept referrals for imaging “other than routine X-rays” from them without physician supervision.

Complaints to the Board of Medical Examiners authored by the radiologist, alleging that the

“...final decision could

have wide-range implications for APRN practice...”

ANCC Announces New Credentials for Advanced Practice Nurses Effective January 2008

The American Nurses Credentialing Center (ANCC) Commission on Certification (COC) has officially announced ANCC’s new advanced practice credentials for clinical nurse specialists (CNSs) and nurse practitioners (NPs). The previous credential, APRN,BC (Advanced Practice Registered Nurse, Board Certified) is retired effective January 1, 2008.

CNS Credentials The new ANCC credential for the advanced

practice role of clinical nurse specialist (CNS) will be CNS-BC. (Clinical Nurse Specialist–Board Certified).

This change has been supported by the major CNS stakeholder organizations, the American Psychiatric Nurses Association (APNA), the International Society of Psychiatric Nurses (ISPN) and the National

Association of Clinical Nurse Specialists (NACNS); ANCC worked closely with these groups to assure that all issues and perspectives were considered. It was also supported by a majority of certified CNSs, who were given the chance to submit their feedback in an ANCC survey, which was posted on the NACNS website. One concern some CNSs had was that the change could undermine their status as advanced practice nurses. According to Kelly A. Goudreau DSN, RN, CNS, Immediate Past President of NACNS, “the CNS role is best served by a unique credential that differentiates the CNS role from that of other advanced practice nurses. In some states the CNS role is not recognized, and state boards allow the NP to practice as a CNS. This trend poses a challenge to the continuation of the unique CNS role. NACNS and ANCC support the independence and continued recognition of the CNS as a separate and distinct advanced practice role. The new CNS-BC credential will help to highlight this important distinction.”

Advanced Practice NursingAPRN Independent Practice Threatened through for the sake of their patients and the future

of advanced practice nursing.Despite community and professional support,

the road blocks to independent practice that APRNs Healy and Theusen experienced have resulted in the closure of the Gold Street Clinic effective January 31st, 2008. The inability to recruit other APRNs, the prohibition of access to the diagnostic tools necessary for the safety of the 6100 patients in the practice, and the weight of the impending lawsuit have contributed to the decision to close the otherwise successful practice.

“It is imperative that Montana Nurses Association continue to support independent nursing practice,” said Barbara Prescott, Chair of the MNA Council on Advanced Practice. She added that it has been recommended that the ANA advance policy through the pursuit of legislation and regulatory language that protects the rights of all APRNs to practice fully within their scope of practice, unencumbered by legal, business, institutional, or regulatory barriers and to monitor development and oppose activities that would constitute restraint of trade against APRNs.

Certification & Certification Renewal News and AnnouncementsNP CredentialsThe new credentials for ANCC-certified nurse

practitioners will be NP-BC (nurse practitioner-board certified) preceded by a letter indicating the particular specialty, i.e.:• FamilyNursePractitioner FNP-BC• AdultNursePractitioner ANP-BC• AcuteCareNursePractitioner ACNP-BC• PediatricNursePractitioner PNP-BC• GerontologicalNursePractitioner GNP-BC• FamilyPsychandMental Health Nurse Practitioner PMHNP-BC (Family will be on the certificate and can be

added if desired) • AdultPsychandMental Health Nurse Practitioner PMHNP-BC (Adult will be on the certificate and can be

added if desired)

Implementation of New Advanced Practice Credentials

ANCC’s new advanced practice credentials go into effect January 1, 2008. ANCC will notify state boards of nursing and other stakeholders of this change. Furthermore, all ANCC-certified NPs and CNSs will receive an updated certificate by mail during the second quarter of 2008, with the new credentials clearly stated. ANCC hopes this will help to avoid or overcome any potential confusion or difficulty.

January, February, March 2008—Montana Nurses Association Pulse— Page 7

E&GW COUNCIL EXECUTIVE COMMITTEE Maria Gurreri, MissoulaAmy Hauschild, Missoula

ANA DELEGATESLori Chovanak, HelenaMelissa Cobb, HelenaAmy Hauschild, MissoulaTina Hedin, BillingsGwyn Palchak, KalispellSusan Porrovecchio, BigforkBarb Prescott, BozemanMaggie Shulund, Stevensville

ANA ALTERNATESMarnie Collett, BelgradeSue Noem, Helena

UAN DELEGATESMaria Gurreri, Missoula Amy Hauschild, MissoulaKate Steenberg, Clinton

UAN ALTERNATEMelissa Cobb, Helena

Election Results & Who’s Who at MNA

MNA 2007 OFFICIAL BALLOT RESULTS

BOARD OF DIRECTORS AT LARGEBrenda Donaldson, LewistownMary Pappas, Havre

BOARD OF DIRECTORS POSITION:COUNCIL ON ADVANCED PRACTICERebecca Sturdevant, Kalispell

BOARD OF DIRECTORS POSITION:COUNCIL ON CONTINUING EDUCATIONGwyn Palchak, Kalispell

BOARD OF DIRECTORS POSITION:COUNCIL ON E&GWVicky Rae Byrd, Helena

COUNCIL ON CONTINUING EDUCATION–APPROVER UNITSusan Porrovecchio, Bigfork

COUNCIL ON CONTINUING EDUCATION–PROVIDER UNITJanene Cotton, Stevensville

COUNCIL ON PRACTICE & GOVERNMENT AFFAIRSMelissa Cobb, HelenaMilly Gutkoski, Bozeman

NOMINATIONS COMMITTEEMaxine Ferguson, HelenaBonnie Hash, BozemanLinda Henderson, Missoula (Chair)

CONGRATULATIONS CANDIDATES

Page 8—Montana Nurses Association Pulse—January, February, March 2008

MNA STAFF

Robert AllenExecutive Director

Bill SmithLabor Relations Specialist

Jolene DevineProjects Manager

2008 Board of Directors

Tina HedinPresident, 2009

Vacant President-Elect, 2009

Lori ChovanakSecretary/Treasurer, 2008

Gwyn Palchak Council on CE Director Position, 2009

Rebecca Sturdevant Council on Advanced Practice Position, 2009

Vicky Rae ByrdCouncil on E&GW Director Position, 2009

Barb PrescottCPGA Director Position, 2008

Brenda DonaldsonDirector at Large, 2009

Mary PappasDirector at Large, 2009

Kim PowellDirector at Large, 2008

Mae RittalDirector at Large, 2008

2008Montana Nurses Association Structural Unit Membership

ANA DELEGATES & ALTERNATES 2008Lori Chovanak . . . . . . . . . . . . . . . . . . . . . . . Helena Susan Porrovecchio . . . . . . . . . . . . . . . . . . . BigforkMelissa Cobb . . . . . . . . . . . . . . . . . . . . . . . . Helena Barb Prescott . . . . . . . . . . . . . . . . . . . . . . BozemanAmy Hauschild . . . . . . . . . . . . . . . . . . . . . Missoula Maggie Shulund . . . . . . . . . . . . . . . . . . . . MissoulaTina Hedin . . . . . . . . . . . . . . . . . . . . . . . . . Billings Marnie Collett, 1st Alternate . . . . . . . . . . . BelgradeGwyn Palchak . . . . . . . . . . . . . . . . . . . . . . Kalispell Sue Noem, 2nd Alternate . . . . . . . . . . . . . . . Helena

ANA / UAN DELEGATESMaria Gurreri . . . . . . . . . . . . . . . . . . . . . . Missoula Kate Steenberg . . . . . . . . . . . . . . . . . . . . . MissoulaAmy Hauschild . . . . . . . . . . . . . . . . . . . . . Missoula Melissa Cobb, 1st Alternate . . . . . . . . . . . . . . Helena

BYLAWS COMMITTEELinda Henderson . . . . . . . . . . . . . . . . . . . . Missoula Teresa Henry, Chair . . . . . . . . . . . . . . . . . Missoula

COUNCIL ON ADVANCED PRACTICEElaine Becker, Dist #6 Co-Rep . . . . . . . . . Great Falls Charlene Pontoriero, Dist #8 Rep . . . . . . . .FairviewPat Carrick, Dist #2 Rep, Sec/Treas . . . . . . . . Dillon Barb Prescott, Chair . . . . . . . . . . . . . . . . . BozemanKeven Comer, Dist #3 Rep . . . . . . . . . . . . . Bozeman Karrin Sax, Dist. #1 Rep . . . . . . . . . . . . . . .FlorencePaul Coats . . . . . . . . . . . . . . . . . . . . . . . . . Whitefish Laureli Scribner, Dist #5 Rep . . . . . . . . . . . . BillingsBeverly Mayberry, Dist #7 Rep . . . . . . . . . Kalispell Rebecca Sturdevant, Rep to BOD, 2009 . . . KalispellKerry Nickou, Dist #6, Co-Rep . . . . . . . . East Glacier Joan VanDuynhoven, Dist #4 . . . . . . . . . . . Condon

COUNCIL ON CONTINUING EDUCATION–APPROVER UNITBonnie Hash, 2008 . . . . . . . . . . . . . . . . . . Bozeman Susan Porrovecchio, 2009 . . . . . . . . . . . . . . BigforkMary Pappas, 2008 . . . . . . . . . . . . . . . . . . . . .Havre Molly Protheroe, Chair, 2008 . . . . . . . . . . . . Helena

COUNCIL ON CONTINUING EDUCATION–PROVIDER UNITJanene Cotton, 2009 . . . . . . . . . . . . . . . Stevensville Gwyn Palchak, Rep to BOD, 2009 . . . . . . . KalispellBrenda Donaldson, 2008 . . . . . . . . . . . . . Lewistown Maggie Shulund, 2008 . . . . . . . . . . . . . StevensvilleDebby Lee, 2008 . . . . . . . . . . . . . . . . . . . . . Denton Pam Windmueller, 2008 . . . . . . . . . . . . . Great Falls

COUNCIL ON PRACTICE & GOVERNMENT AFFAIRSMilly Gutkoski, 2009 . . . . . . . . . . . . . . . . . Bozeman Melissa Cobb, 2009 . . . . . . . . . . . . . . . . . . . . HelenaLynn Hebert, 2008 . . . . . . . . . . . . . . . . . . Sun River Rebecca Sturdevant, 2008 . . . . . . . . . . . . . KalispellShelly Meyer, 2008 . . . . . . . . . . . . . . . . . . Missoula

DISTRICT LEADERSHIPMaggie Shulund, Dist. #01 . . . . . . . . . . . . . Missoula Tina Hedin, Dist. #05 . . . . . . . . . . . . . . . . . BillingsBarb Prescott, Dist. #03 . . . . . . . . . . . . . . . Bozeman Angela St. John, Dist. #07 . . . . . . . . . . . . . KalispellLynne Maierle, Dist. #04 . . . . . . . . . . . . . . . . Helena Pam Windmueller, Dist #06 . . . . . . . . . . . Great FallsVacant, Dist. #02 . . . . . . . . . . . . . . . . . . . . . . . Butte

EDITORIAL BOARDLynn Hebert, Chair . . . . . . . . . . . . . . . . . . Sun River Barbara Prescott . . . . . . . . . . . . . . . . . . . . BozemanMary Pappas . . . . . . . . . . . . . . . . . . . . . . . . . .Havre Mae Rittal . . . . . . . . . . . . . . . . . . . . . . . . . . . Sidney

E&GW EXECUTIVE COMMITTEEVicky Rae Byrd, Rep to BOD, 2009 . . . . . . . . Helena Edi Martin, 2008 . . . . . . . . . . . . . . . . . . . . MissoulaMaria Gurreri, 2009 . . . . . . . . . . . . . . . . . Missoula Sue Noem, 2008 . . . . . . . . . . . . . . . . . . . . . . HelenaAmy Hauschild, 2009 . . . . . . . . . . . . . . . . Missoula

FINANCE/FUNDRAISING COMMITTEELori Chovanak, Chair . . . . . . . . . . . . . . . . . . Helena Sue Nieuwenhuyse . . . . . . . . . . . . . . . . . . . . .HavreDave Fisher . . . . . . . . . . . . . . . . . . . . . . . . . Billings Gwyn Palchak . . . . . . . . . . . . . . . . . . . . . KalispellSue Honsky . . . . . . . . . . . . . . . . . . . . . . . Missoula Arlys Williams . . . . . . . . . . . . . . . . . . . . . .Chinook

HISTORY COMMITTEEMary Munger, Chair . . . . . . . . . . . . . . . . . . . Helena Therese Sullivan . . . . . . . . . . . . . . . . . . . . . . HelenaHerva Simpson . . . . . . . . . . . . . . . . . . . . . Bozeman

LOCAL UNIT LEADERSHIPAnaconda Community . . . . . . . . . . . . Loretta Phillip MT State Hospital . . . . . . . . . . . . . . . . .Tiona JuarezBozeman Deaconess . . . . . . . . . . . . . . Linda Brown Northern MT Hospital . . . . . . . . . . . . . . Doug BraunButte/SB City County . . . . . . . . . . . Sophia Aanstad Northern Rockies Medical . . . . . . . . . . . Jean McRaeCascade City/County . . . . . . . . . . . . . . .Rayna Joshu Partners in Home Care . . . . . . . . . . . . Kathy WilsonClark Fork Valley Hospital . . . . . . . . Kristine Ziegler Public Health & Human Services . . . Marcy EckersonCMC–Missoula . . . . . . . . . Monica Brooke, Co-Chair Rosebud County . . . . . . . . . . . . . . .Lorie VanDonselCMC–Missoula . . . . . . . . . .Angela Lovato, Co-Chair St. James Healthcare . . . . . . . . . . . . . . . Robin FoleyBillings Clinic . . . . . . . . . . . . . . . . . . . . . Keri Cross St Johns Lutheran . . . . . . . . . . . . . . . .Deb StoddardGlendive Medical Center . . . . . . . . . . . Stacey Dalton St. Patrick Hospital . . . . . . . . . . . . Edi Martin, ChairMarcus Daly Memorial . . . . . . . . . .Norma Severson St. Peter’s Hospital . . . . . . . . . .Sue Noem, Co-ChairMSU Student Health . . . . . . . . . . . . . .Bonnie White St. Peter’s Hospital . . . . . Daylynn Struble, Co-Chair Veterans Home . . . . . . . . . . . . . . . . . . Irma Michels

NOMINATIONS COMMITTEEMaxine Ferguson, 2009 . . . . . . . . . . . . . . . . . Helena Bonnie Hash, 2009 . . . . . . . . . . . . . . . . . . BozemanLinda Henderson, Chair, 2009. . . . . . . . . . Missoula

STRUCTURAL UNIT CHAIRSBarb Prescott, CAP Exec Committee Linda Henderson, NominationsLori Chovanak, Finance/Fundraising Mary Munger, HistoryTo be elected, E&GW Exec Committee Pam Windmueller, Provider UnitLynn Hebert, Editorial Board Kim Powell, Practice & Government AffairsTeresa Henry, Bylaws Molly Protheroe, Approver Unit

Special thanks to Lauren McGrane, Mary Thompson, Molly Protheroe and Kim Mackay (left to right) for volunteering to count the 2007 election ballots on December 18, 2007.

Election Results & Who’s Who at MNA

January, February, March 2008—Montana Nurses Association Pulse— Page 9

2008 MNA Convention

MARK YOUR CALENDAR!!!

MNA 96th ANNUAL CONVENTION

OCTOBER 2-4, 2008HELENA, MT

It is time to prepare for nominating recipients of the MNA 2008 awards. Please review the election criteria and contact your District President, the MNA office or log on to our website

www.mtnurses.org to obtain nominations forms. Entries

must be received by the MNA office no later than July 31, 2008.

Political Nurse Leadership Award–founded in honor of Mary

Munger, RNThis award recognizes a member who has

made significant contributions to nursing practice and health policy through political and legislative activity. A candidate must:

• Promote the nursing profession in political and health care arenas,

• Advance the knowledge of nurses, politicians, and policy makers concerning nursing and health care issues,

• Demonstrates political leadership at the district, state, or national levels,

• Serve as a mentor and role model to other nurses in the political process,

• Seek opportunities to advance Nursing’s legislative agenda through grassroots activity.

Distinguished Nurse of the Year Award–founded in honor of Trudy Malone, RN

This award recognizes a member of MNA for outstanding contributions made to professional nursing. A candidate must:

• Demonstrate dynamic leadership in promoting excellence in nursing,

• Demonstrate the knowledge of current issued in relation to the goals of the nursing profession,

• Show a keen awareness and commitment to professional nursing ethics,

• Initiate positive action toward the improvement of patient care,

• Demonstrate the ability to work well with other members of the health care team.

MNA Award for Excellence for Advanced Practice Registered Nurse of the Year–

This award recognizes an APRN who has demonstrated excellence in their practice specialty area and who has made significant contributions to health care and the professional growth of APRNs. A candidate must:

• Demonstrate excellence as an APRN and as a role model for other APRNs and the nursing profession in general,

• Be involved as a preceptor, educator, advocate,

nominating recipients of the MNA 2008 awards. Please

www.mtnurses.orgwww.mtnurses.orgnominations forms.

must be received by the MNA office no later than July 31, 2008.

in the political arena, etc.,• Have made a significant contribution to the

improvement of health care for individuals, families or communities,

• Be creative in his/her approach to nursing care,• Have a positive effect on clients and on

colleagues,• Utilize current research in practice.

Economic & General Welfare Achievement Award–founded in honor of Eileen Robbins, RN

This award recognizes nurses at the local unit level who have influenced their work setting through collective bargaining activities. A candidate must:

• Demonstrate commitment to professional nursing via individual practice competency and continuing educational growth,

• Use contract language to define, monitor, and enhance nursing practice in the work environment,

• Function as an active leader within the local unit through past or present elected office and committee participation.

MNA Historian Award–This award recognizes an MNA member who

has demonstrated a consistent, distinct interest in nursing history. A candidate must:

• Participate in preservation of historical nursing documents,

• Promote interest in nursing history,• Promote MNA’s History & Literary Endowment

Fund.

Excellence in Nursing Education Award–founded in honor of Peggy Mussehl, RN (Continuing Education), and Anna Shannon, RN (Formal Education)

This award recognizes a member(s) of MNA for professional nurse contributions in the field of either formal education and/or continuing education. A candidate must:

• Have significant involvement and commitment to advancing nursing education,

• Expand the body of nursing knowledge through research or other scholarly activities,

• Challenge learner to achieve optimal level of accomplishment.

MNA Award for Excellence for Advanced Practice Registered Nurse Advocate of the Year–

This award recognizes a non-APRN in Montana who has made a significant contribution to the state of health care and/or the practice of APRNs in Montana. A candidate must be a/an:

• Community leader who has made a significant contribution to individuals, families communities and the health care system,

Hear ye, Hear ye….Nominations Sought for MNA 2008 Awards

• Individual who has had a positive impact on the professional growth of APRNs.

Friend of Nursing Award–founded in honor of Barbara Booher

This award recognizes a non-nurse who has advocated for and/or significantly advanced nursing in Montana. The candidate must:

• Show significant long-term contributions made by a non-nurse to Montana’s professional nursing community,

• Facilitate significant accomplishments for the Association,

• Play a key role in assisting major successes within the professional nursing community.

PRESENTERS!Share your expertise!

CONVENTION ALERTCALL FOR ABSTRACTS:

ONLINE FEBRUARY 15, 2008SUBMISSION DEADLINE MAY 15, 2008

www.mtnurses.org

Page 10—Montana Nurses Association Pulse—January, February, March 2008

First Parish Nurse Course completed in Wyoming

Registered nurses from several Wyoming communities gathered in Casper, Wyoming, May 14-17, 2007 for the first ever Wyoming Parish Nurse Preparation Course sponsored by the Carroll College Parish Nurse Center. This 35-hour preparation course was under the direction of Dr. Cynthia Gustafson with special assistance from Parish Nurse Edna Kinsella of Missoula, Montana, parish nurse at Christ the King Catholic Parish, Missoula.

Plans are underway to offer a preparation course in Wyoming in June 2008. This would be open to nurses in Montana as well as across the region. For more information contact the Carroll College Parish Nurse Center.

Recent publication:The new 7th edition textbook (2008) of Public

Health Nursing: Population-Centered Health Care in the Community edited by M. Stanhope and J. Lancaster includes a chapter written by Cynthia Gustafson titled: The Nurse in Parish Nursing.

Wyoming nurses discuss challenges of parish nursing during the first ever parish nurse class in Wyoming.

Parish Nurse Renewal Program PlannedCynthia Gustafson, PhD, RN

We at the Parish Nurse Center at Carroll College are excited to announce that plans are underway to offer a renewal program for all parish nurses and health ministers. Come and join your colleagues in a time of gathering new information, sharing of stories, meals and worship, as well as a time for individual prayer and reflection. Patte Paquette will be our retreat leader. Patte was in the first parish nurse preparation course in Montana in 1998, and has served as a parish nurse in Montana and Kansas. She has returned to Billings and serves as a hospital chaplain for Big Sky Hospice.

The tentative schedule is to start at 1 pm on Friday, April 11, 2008, and end with an 11 am worship service on Sunday, April 13. We will have keynote presentations and a celebratory feast on Friday, with an opportunity to share the successes and challenges of health ministry. Participants will be asked to bring a best practice model to share with the group.

On Saturday participants can choose from a variety of workshops. One topic will be the use of web-based resources for health information with Gail Kouame from the National Network of Libraries of Medicine, University of Washington. Ms. Kouame has been a featured speaker in past parish nurse courses. Sharlene Kolb has published a book and will lead a workshop on journaling. Other topics include updates in health assessment and pharmacology, CPR and AED update, working with persons with diabetes, and holistic healing modalities. Students will be able to use the new Carroll College Department of Nursing Holistic Healing Lab as well as our nursing simulation labs.

Housing will not be available on campus, but we are working on housing options to offer in Helena. A brochure will be sent out in early 2008. We will be applying for continuing education credit through MNA. For more information and to receive a brochure contact Sharlene Kolb, Carroll College Parish Nurse Center at skolb@carroll.edu or 406-447-4367.

Parish Nursing

Cynthia Gustafson

MSU Begins Clinical Nurse Leader Graduate OptionCharlene Winters, PhD, APRN, BC, CNL, Project DirectorKate Siegrist, MSN, CNM, CNL Recruiter

Montana State University at Bozeman began the fall semester with a new graduate track. The Clinical Nurse Leader (CNL) option prepares nurses for clinical leadership in all health care settings, to implement outcomes-based practice and quality improvement strategies, and manage microsystems of care. CNLs are master’s prepared nurses with advanced nursing knowledge for setting specific practice at the point of care. Graduates of CNL programs have advanced nursing knowledge but do not meet the criteria for advanced practice nursing (APRN). According to Dr. Marcia Stanhope, consultant to MSU’s CNL program, the CNL should be considered a “master’s in leadership” Dr. Stanhope met with MSU faculty in early October and provided insight into the development and implementation of the CNL role in health care settings across the U.S. CNL graduates are prepared to function in the roles of clinician, outcomes manager, client advocate, educator, information manager, system analyst/risk anticipator, team manager, and member of a profession. CNLs practice in a wide variety of settings including acute care, long term care, home health care, public health, and critical access hospitals.

MSU received funding from the Health Resources and Services Administration (HRSA) for the CNL program. A graduate student attending MSU can complete all required coursework in one academic year (3 semesters-fall, spring & summer) or longer if the student prefers to attend part time. Courses are taught using distance learning technologies (WebCT) using the Internet with minimal real-time meetings. Students accepted into the first cohort began taking core classes fall semester with the family nurse practitioner (FNP) and clinical nurse specialist (CNS) students. They will begin CNL specific clinical courses spring semester and full time students will complete a clinical immersion experience in the summer. Clinical rotations, supervised by a faculty-preceptor dyad, are completed in the student’s home community whenever possible.

Nurses interested in learning more about the CNL option are encouraged to visit the College of Nursing website at http://www.montana.edu/nursing/academic/mn.htm or contact Ms. Lynn Taylor, the graduate program Administrative Assistant at lynnt@montana.edu or (406) 994-3500. Applications for admission for fall 2008 are due February 15, 2008.

January, February, March 2008—Montana Nurses Association Pulse— Page 11

Annual Chico RetreatNurse activists and leaders from around Montana

will once again gather at the Annual E&GW Retreat at Chico Hot Springs, April 21st and 22nd to develop strategies around local unit communication, internal organizing, leadership development and nurse governance issues. Time will also be spent on such collective bargaining basics as employment rights protected by your contract, the job of the union steward and ways to use Professional Conference Committees and “Assignment Despite Objection” forms effectively. Plan to attend by saving these dates on your calendar today! If you have questions, call Robert Allen at 442-6710.

E & GWfirst office visit. Frustrated with the situation, Dr. Shaalen reached out to the local religious leaders. He noted some success in getting women in to see a physician at the earliest recognition of symptoms following that. The Clerics or Holy Men have shown willingness to educate men, after their devotion hours, and to give men “permission” to allow their wives to seek medical treatment. This success also shows how small, culturally-sensitive steps can make a big difference.

The two days we delegates spent together at the summit were a whirlwind of information-sharing, review of staggering statistics and recognition of seemingly impossible barriers. Not having experienced the ravages of war within our borders, or the severe lack of medical professionals, technicians, and equipment that we consider basic; the US delegates often felt overwhelmed by the complexities our peers were dealing with.

We did share one basic tenet: impassioned people can make a difference. “Never doubt that a small group of thoughtful committed citizens can change the world; indeed, it’s the only thing that ever has.” Margaret Mead’s famous quotation may seem cliché yet it struck me as the focus and unifying concept of this diverse group. Problems were delineated, brainstorming for solutions performed, connections were made and the successes and progress continue: an exchange of equipment between Kenya and Pennsylvania, a first time Breast Cancer Survivor conference in both India and Romania, an invitation to an Atlanta, Georgia delegate to attend a conference in the country of Georgia… additional small steps leading to improving the lives of women around the world. And there is much yet to do.

Mother Teresa, when discussing the need for each individual to become part of the solution to problems, stated: “Do not wait for leaders; do it alone, person to person.” Nurses know this well–small steps, small interventions, when added together can change the course of a disease or problem.

There are many heroes around the world we can use to model our efforts after: Yuthar Mohammed Al Rawahy who developed “The National Association for Cancer Awareness” in the Sultanate of Oman; Dr. Mohammed Shaalen of Egypt who initiated unprecedented partnerships for women’s health; Mary Onyango of Nairobi, Kenya who established the “Kenya Breast Health Programme” after her own diagnosis; and Dr. (Mrs.) Roshan Chinoy, Head of Pathology at Tata Memorial Centre in Mumbai, India who speaks for impoverished women and seeks a way to make inroads against the devastation that breast cancer wreaks on her beloved country. Just a sampling of the courageous men and women I’ve had the privilege to meet. Join these heroes and add your “small steps” to theirs. (See Breast Cancer: What Montana Nurses Can Do on page ?) Together we can find a cure.

Kim Powell, left, and Dr. Mrs. Rama Sivaram take a moment to share experiences. Dr. Sivaram is Director of Counseling and Outreach at the Prashanti Cancer Care Mission in Pune, India. She brought out the cultural challenges of improving breast care awareness and treatment when she related that body image and discussion of women’s bodies was taboo in India. A breast cancer survivor and art historian, Dr. Sivaram is trying to use art as a way for women in her country to identify issues with their bodies and increase there comfort level in seeking assistance. She noted that she is considered somewhat of a radical in her country.Images of Budapest: The Parliament across the Danube River.

Delegates enjoy a night out for the annual walk across the Chain Bridge in Budapest. The bridge was bathed in pink and thousands of Budapest citizens march for breast cancer awareness and in memory of breast cancer victims. Pictured are: Far left, Selma Morris who was invited to speak in the former soviet republic

of Georgia; slightly in front of her, Gertrude Nakigudde from Uganda; front center, Nafisa Malik from Tanzania; back center, Dr. Dr. Mohamed Shaalan from Egypt and is a breast surgeon.

Ignite the Promise . . .(continued from page 1)

Images of Budapest: The Buda Hills flanking the Danube River. In the foreground is an old palace and fort where the First Lady of Hungary, Dr. Klara Dobrov, hosted a reception for all the delegates.

Ranjit Kuar, a breast cancer advocate from Malaysia, speaks about an innovative breast cancer awareness/screening program in Malaysia.

Images of Budapest: The Parliament across the Danube River.

Page 12—Montana Nurses Association Pulse—January, February, March 2008

Maxine Ferguson, RN

MNA has its first online continuing education activity! In October 2007, the MNA course, Workplace Violence in Rural Healthcare, was first made available online. The course offers 1.5 continuing education contact hours. The course is possible through a Susan Harwood grant (number 46H5-HT06) from the OSHA Office of Training and Education. MNA received the grant in partnership with the Montana Laborers AGC Training Program. Pat Wise (formerly MNA), and Felicity McFerrin (Laborers AGC) guided the development process from their joint perspectives of valuing collaborative efforts to advance violence prevention education for rural and remote workers in many industries and businesses. Sharon Howard and Jan Kiely from Insights and Solutions developed the content.

“According to the National Institute for Occupational Safety and Health (NIOSH), workplace violence is defined as any physical assault, threatening behavior or verbal abuse occurring in a work setting.”The manual developed for the course assists rural

healthcare workers and their employers to identify

NURSING—TOGETHER WE SHINEOne-Day Educational Nursing Conferenceat Carroll College

On May 9th, 2008, the Carroll College Department of Nursing, in conjunction with VA Montana Healthcare System and St. Peter’s Hospital, will be hosting its 4th annual continuing education conference for nurses in celebration of Nurses’ Week. The “Nursing—Together We Shine” conference will be held on the Carroll College campus in Helena and continuing education credits from the Montana Nurses Association will be available (pending approval). All RNs, LPNs and student nurses are invited!

Topics will include presentations on dermatological skin care, sleep apnea, cultural care and pandemic flu. There will also be an opportunity for audience members to analyze case studies and answer questions anonymously utilizing our interactive participant response system. Nursing research presentation topics such as American Indian spirituality, alcohol related ER admissions in adolescents, families with diabetes, living with asthma, myocardial infarction, polycystic ovary syndrome, and necrotizing enterocolitis will be included in the afternoon session. Participants will have the opportunity to tour Carroll’s simulated nursing labs and interact with an array of automated manikins.

Carroll College is committed to providing continuing education and development for the nurses of Montana. With the dynamic healthcare environment of today, it is increasingly important for nursing institutions and nurses at all levels to come together to support each other and life-long education in order to meet Montana’s healthcare needs.

To request a conference brochure, please contact Terri John, secretary of the Carroll College Department of Nursing, at (406) 447-5491 or tjohn@carroll.edu.

On June 29, 1988, the U.S. Supreme Court examined agency fees in the context of those private sector employers and unions falling under the authority of the Labor Management Relations Act. The Court issued a decision; Communication Workers of America v. Beck. The Court found:

“Section 8(a)(3) of LMRA, which permits employer and union to enter into union-security agreement, does not permit union, over objection of agency-fee payer, to expend agency-fee funds on activities beyond those germane to collective bargaining, contract administration, and grievance adjustment.” (128 LRRM at 2729)

In compliance with the Beck decision the Montana Nurses Association has compiled a document entitled Procedure for Determining Amount of Service Fee to be Charged by Montana Nurses Association. The following is a description of the chargeable portion of Association expenditures under Beck.

“Chargeable activities means those activities engaged in by the Montana Nurses Association that is recognized as the exclusive collective bargaining representative for which each employee in the bargaining unit lawfully may be required to pay his or her per capita share of the cost.”

Also contained in the Association procedure is a section entitled Explanation of Chargeable Fee If You Elect Not to Become A Member of Montana Nurses Association. This explanation states:

“If you elect not to become a full member, you will not have any voting rights or right to participate in the governance of the American Nurses Association, the Montana Nurses Association or the Local Association.”

“If you do not become a member, you will be required to pay fair share fee which is equal to your proportionate share of the costs of the collective bargaining process, contract administration and related matters effecting wages, hours and other conditions of employment.”

OBJECTIONS TO AMOUNT OF ASSOCIATIONDETERMINED SERVICE FEE

Any Potential Objector who believes that a portion of his or her the Association-Determined Service Fee shall be used to fund non-chargeable activities may object to the amount of said fee by mailing a notice of objection to Montana Nurses Association, 20 Old Montana State Highway, Clancy, MT 59634, or by delivering such a notice to Montana Nurses Association at said address. The notice of objection shall be in written form and shall include the objector’s name, home address, and a statement that he or she objects to the amount of the Association Determined Fee. Any Potential Objector who accepts the Association-Determined Service Fee shall send or deliver a notice accepting that fee to the same address. If the Montana Nurses Association does not receive timely notice, it will be presumed the Potential Objector has no objection to paying a service fee equal to dues. In order to be timely, the notice must be postmarked or delivered within 30 days of receiving the information referred to in Section III (B).

Continuing Education

Maxine Ferguson

and reduce the risk of workplace violence in their places of employment. There are two formats:

PART 1: A practical guide designed to assist the reader in identifying and understanding workplace violence and to develop realistic strategies for dealing with the issue. This format is intended to serve as a functional resource from which the reader can get information and identify additional resources for developing effective strategies for dealing with workplace violence in rural healthcare settings.

PART 2: An academic analysis of the history, sources and preventive strategies currently being utilized to deal with workplace violence in rural healthcare settings. This format allows the reader to earn Continuing Education credit for the completion of the review while developing effective workplace strategies to deal with violent situations.

To access this course, go to the MNA website, www/mtnurses.org and click on the appropriate link. You can order a manual to accompany the course by contacting MNA, or you can download the materials. There is no cost for the manual or the course. Contact MNA by Email at info@mtnurses.org or send a written request to MNA, 20 Old State Highway, Clancy, MT 59634, or call MNA at 406/442-6710. We hope that all nurses and others who work alone or in isolated areas will take advantage of this course! If you have already taken the course, we would appreciate your feedback about its helpfulness, ease of use, etc. Thank you!

Online Continuing Education Offered by MNA

Service Fee Notice

January, February, March 2008—Montana Nurses Association Pulse— Page 13

News from Sigma Theta Tau International ZU Chapter-at LargeGlenna Burg, MS, RN, BC and President of Zeta Upsilon Chapter-at-Large, Sigma Theta Tau International

Mark your calendars now for two important upcoming Sigma Theta Tau International-Zeta Upsilon Chapter-at-Large events. The annual ZU meeting and induction of new members will take place at 1 PM on Saturday, April 5, 2008 in Bozeman. The location will be announced at a later date. This year Zeta Upsilon-at Large and the Montana State University-Bozeman College of Nursing are co-sponsoring the Spring Program. Dr. Carol Picard, immediate past president of Sigma Theta Tau International, will present a leadership workshop from 1:00-4:30 PM on Thursday, May 8, 2008 in Bozeman. There will not be any charge for the program and all nurses (members and non-members) are invited to attend. An application for contact hours will be requested through the Montana Nurses Association. The location of the program will be announced at a later date. For more information please contact Glenna Burg at 406-994-2650 or at grburg@montana.edu.

Glenna Burg

LeAnn Thieman

The United States is expected to be short a half-million nurses within the next ten years (plus 750,000 nursing assistants). Understandably, recruitment and retention are top priorities for hospitals and healthcare organizations.

At a recent healthcare event, several human resource staff members and chief nursing officers were lamenting about the frustrations and challenges of getting good nurses to sign on and the current staff to stay on.

“I don’t understand it. We offer a hefty sign on bonus. They take it, and then leave after a year.”

“One hospital gave Volkswagen Bugs as sign on bonuses…I wonder if that worked.”

“We offer subsidized housing.”“We offer a good healthcare benefit package. I

know that helps.”“We pay tuition reimbursement. But once they

graduate, they leave!” “We have a great tract for them to climb the

Clinical Ladder, but it seems nurses don’t measure success the way they used. Now ‘success’ means time off and balance with the rest of their lives.”

“Some of the best nurses we’ve have had the longest are leaving. How do we make them want to stay?”

With increased acuity of care, demanding staffing ratios and challenging working conditions, nurses are not signing on and staying just for the money. They are opting for employers who care about them, professionally and personally. How they are treated on the job is a primary factor in their satisfaction, their resistance to burnout, and their willingness to be a long-term loyal employee. Work-life balance is often their top priority.

Recent data from a Harris Interactive survey reveals enlightening information on workforce attitudes. It shows a continued disconnect between employers and employees, relating to the effectiveness of various staff retention tactics. The study claims only 13 percent of employees say their employers put effort into keeping them on their jobs.

Considering that it costs approximately $50,000 to recruit and hire a new nurse, organizations are eager to retain the ones they have, while attracting the emerging workforce. Many have learned that to do so, they cannot simply offer more money or even bigger benefits.

To keep good nurses, they need to give them a hefty dose of their own medicine: TLC.

Following these 10 tips, treating nurses with the same competent, compassionate TLC that they give their patients, will inspire them to sign on and stay on:1) Smile a lot. Be kind. Visit them often. No

matter how busy you are, don’t act rushed or distracted. Make them comfortable around you and allow them to speak their feelings, ideas and needs.

Give Nurses a Dose of Their Own Medicine: Treat Them With TLC

2) Ask, “How can I help you?” Don’t assume that you or the consultants know. Hold a meeting, do a survey, and at the next employee evaluation, ask them sincerely what they need.

3) Do an “assessment” using the former SOAP charting method.

Subjective: ask for their input on their “condition.” Objective: note what you observe. Assessment: evaluate the situation with the person, then make a Plan and implement it.

4) Be prompt in answering their “call lights.” Address their concerns and attempt to meet their needs as soon as possible.

5) Explain all “procedures” and changes and reiterate why they are important. While it may not be an easy course, make clear the good that will come from it. Reinforce how their cooperation and positive approach will greatly affect the outcome.

6) Communicate often and clearly. Keep them up to date with what is happening so they feel involved and less afraid. Listen awhile without talking. A gentle touch on the hand or shoulder conveys sincerity and interest.

7) Ease their “pain.” Though it is sometimes impossible to take away all the discomfort, honest efforts to do so go along way toward relieving it.

8) Promote independence and self-sufficiency. Help them be stronger. Give them as much control as possible and they are more likely to cooperate with the “treatment plan.”

9) “Change positions.” Being in the same position too long can sometimes be uncomfortable. Suggest a transfer within the department or organization. Offer flexible shifts or job sharing.

10) Give them “nourishment.” Help nurture their minds, bodies and spirits. Encourage them to care for themselves as attentively as they do others. Remind them to take breaks, eat meals, and ask for help. Provide inspirational, encouraging books, periodicals, retreats and speakers.

Implementing these 10 tips creates a “care plan” that does not coddle employees, but strengthens and empowers them. This transcends to their patient care, which is reflected in positive patient satisfaction, outcomes and a healthy bottom line.

Giving nurses a dose of their own medicine results in increased productivity and retention. With a little TLC…Trusted Loyal Communication, on their part and yours… everybody wins.

ABOUT THE AUTHORLeAnn Thieman, LPN, CSP, is a nationally

acclaimed speaker and co-author of the new book, “Chicken Soup for the Nurse’s Soul, Second Dose.” As an expert in healthcare recruitment and retention, LeAnn helps inspire and hire nurses, caregivers, and healthcare professionals. For more information about her books and presentations visit: www.NurseRecruitmentandRetention.com or call 1-877-844-3626.

LeAnn Thieman

Page 14—Montana Nurses Association Pulse—January, February, March 2008

Montana Nurses Association

20 Old Montana State Highway • Clancy, MT 59634 • 406/442-6710 • 406/442-1841 Fax

Membership Category (check one)

M Full Membership Dues� Employed - Full Time� Employed - Part Time

R Reduced Membership Dues� Not Employed� Full Time Student� New graduate from basic nursing education

program, within six months after graduation (first membership year only)

� 62 years of age or over and not earning morethan Social Security allows

S Special Membership Dues� 62 years of age or over and not employed� Totally disabled

Please Note:$5.42 of the CMA member dues is for subscrip-tion to The American Nurse. $16 is for subscrip-tion to the American Journal of Nursing. Variousamounts are for subscriptions to CMA/DNAnewsletters. Please check with your CMA officefor exact amount.

State nurses association dues are not deductibleas charitable contributions for tax purposes, butmay be deductible as a business expense.However, that percentage of dues used for lobby-ing by the CMA is not deductible as a businessexpense. Please check with your CMA for the cor-rect amount.

TO BE COMPLETED BY CMA:

__________ __________ ___________STATE DIST REG

Expiration Date ________ / ________Month Year

Choice of Payment (please check)� E-Pay (Monthly Electronic Payment)

This is to authorize monthly electronic paymentsto American Nurses Association, Inc. (ANA). Bysigning on the line, I authorize my ConstituentMember Association (CMA/ANA ) to withdraw1/12 of my annual dues and any additional serv-ice fees from my account.

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

� Credit Card: Please complete the credit card information below and this credit card will be debited on or after the1st day of each month.

Monthly Electronic Deduction AuthorizationSignature

� Full Annual Payment

Membership Investment _______ANA-PAC (Optional—$20.04suggested) _______Total Dues and Contributions _______

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

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__________________________________________Signature for Payroll Deduction

Please mail your completed application with pay-ment to your STATE NURSES ASSOCIATION or to:

Montana Nurses Association20 Old Montana State Highway

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* By signing the Monthly Electronic DeductionAuthorization, or the Automatic Annual Credit CardPayment Authorization, you are authorizing ANA tochange the amount by giving the above-signed thirty(30) days written notice. Abovesigned may cancel thisauthorization upon receipt by ANA of written notifica-tion of termination twenty (20) days prior to deductiondate designated above. Membership will continueunless this notification is received. ANA will charge a$5 fee for any returned drafts or chargebacks.

DATE ________________________________

__________________________________________________ ________________________________ ________________________Last Name/First Name/Middle Initial Home Phone Number Social Security Number

__________________________________________________ ________________________________ ________________________Credentials Work Phone Number Basic School of Nursing__________________________________________________ ________________________________ ________________________Preferred Contact: Home _____ Work_____ Fax Number Graduation (Month/Year)

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

DISTRICT CONTACTS

District 1Meetings every first Tuesday of the month September through April at CMC–for more information contact:

Maggie ShulundHome–(406) 777-5404Work–(406) 329-4021Email: magshu2000@yahoo.com

District 2Vacant

District 3Barb PrescottHome–(406) 585-1393Email: doctorbarb1@msn.com

District 4Lynne MaierleHome–(406) 442-6128Work–(406) 444-2397Email: lmaierle@stpetes.org

District 5Tina HedinHome–(406) 252-3552Work–(406) 435-1500Email: todream161@aol.com

District 6Pam WindmuellerHome–(406) 771-7453Work–(406) 455-5375Email: wimdpama@benefis.org

District 7Angela St. JohnHome–(406) 892-1003Email: cntryclinic@yahoo.com

District 8Vacant

Maggie Shulund

Barb Prescott

Tina Hedin

Pam Windmueller

❑ State Only Membership Dues $200 annual plus $5 processing fee. Members covered under collective bargaining agreement not eligible.

Please Note:$5.42 of the CMA member dues is for subscription to The American Nurse. $20.00 is for subscription to the American Nurse Today.

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