kentucky - d3ms3kxrsap50t.cloudfront.net€¦ · lexington, ky 40503 e-mail: [email protected]...

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current resident or Presort Standard US Postage PAID Permit #14 Princeton, MN 55371 President’s Pen . ........................ 1 Chapter Updates ...................... 3-5 Human Touch Collection: Empathy ........ 5 Calendar of Events ...................... 6 Accent on Research: Data Bits............ 7 Unrecognized Epidemic Kills Farmers ..... 8 Personal Experience .................... 10 KNA Education Summit .................. 11 ANA News........................... 12-14 Membership Application ................ 13 KNA Centennial Video .................. 14 The Human Touch Painting .............. 15 The Of fcial Publication of the Kentucky Nurses Association | Quarterly publication direct mailed to approximately 83,000 Registered Nurses & LP Ns in K entucky INDEX President’s Pen Kathy Hager CHAPTER UPDATES PAGES 3-5 KNA EDUCATION SUMMIT PAGE 11 STEPPING INTO A CULTURE OF SAFETY PAGE 12 S E E W H A TS IN SID E KENTUCKY AN AWARD WINNING PUBLICATION NURSE Oct, Nov, Dec 2017 | Volume 65 | No. 4 Do you want to be part of something great? Let’s: get nurses healthier and happier – and the people for whom we provide care healthier and happier, too support increasing the number of health-insured Americans work toward a more stable insurance market-place preserve preventive care Greetings, Kentucky Nurses: With each newsletter, I try to remind myself of the goals KNA has established: Healthier and happier nurses KNA an organization, of which all nurses feel honored to be members Governance by Chapters and Board of Directors Membership growth, allowing more nursing presence everywhere - on Boards, in health care organizational leadership, research participation, leading health promotion agendas KNA has been very busy this year. As you know, there has been quite a lot going on in Kentucky and in the US over the past few months, related to health care. Kentucky is considering an 1115 waiver at this time; it proposes to expand Medicaid in a manner different from the Affordable Care Act’s (ACA, Obamacare) proposal. There are several features of the waiver to which KNA is opposed. We do not want people’s health care to be dependent on their providing community service. Despite the fact that we strongly recognize every American’s civic obligations, we do not want their healthcare hinging upon community service. Whatever innovative insurance waiver we propose, we want it to increase the number of people covered, making the care better and serving more people equitably. We want to expand Medicaid, so that people who are near the poverty level will receive assistance in getting insured; we believe health care is a right. KNA has also been speaking out for improved health care at the national level as well. We support bipartisan review of the ACA care, with revisions as needed. At the KNA office, much has been going on! Melissa Mershon, our interim ED, has been with us six months, and has been working tirelessly (with Lisa and Michelle – and many KNA members) on multiple projects: Hosting a Leadership Retreat (where Board directors, Cabinet and Committee members, and Chapter leaders) where KNA dreamed of where we are going KNA website ° an on-line calendar of events for KNA (including chapter meetings), for Kentucky Board of Nursing events, for our sub- specialty group events, and for health advocacy programs (google Kentucky Nurses Association and look under Events in Kentucky) http://www.kentucky-nurses.org/ Homepage-Category/Upcoming-Events/EVENTS-IN- OUR-STATE.html ° links to special services Monthly e-newsletter-to highlight KNA events and nurses Nightingale tribute across the state – stay tuned for this one – you will be proud of what Melissa has in mind in this area Delivering CPR manikins to all school districts who requested them – this was in support of CPR being taught at the high schools (long term project of past Governmental Affairs Chair, Shawn Nordheim) Reviving the Kentucky Nurses Foundation (with the help of Jo Singleton and the Board of Trustees) Coordinating the Summit in two locations (Louisville, Nov 2 / Teena Darnell, event planner; Lexington, Nov 3 / Carla Hamilton, event planner): Drowning in Substance Use, Focusing Upstream Re-writing a white paper on the use of medicinal marijuana, consistent with ANA’s white paper of 2016. We are pushing for marijuana to be rescheduled; once it is rescheduled in the US, research can be completed that will allow us to know its benefits and risks. KNA is co- sponsoring an event on medicinal marijuana. This event is in Louisville, September 29th, 2017, 8:30-4:05 pm. Two KNA members were distinguished with the title of FAAN – Fellows of the Academy of Nursing. This honor is awarded to nursing leaders in education, management, practice and research. We are so proud of Kentucky’s newest members, Dr. Dorothy Brockopp and Dr. Sheila Melander. Congratulations to both of them. President’s Pen continued on page 5

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Page 1: KENTUCKY - d3ms3kxrsap50t.cloudfront.net€¦ · Lexington, KY 40503 E-mail: kendra_foreman@msn.com TREASURER: Nancy Garth, RN C: 859-312-0599 3292 Shoals Lake Drive H: 859-271-9529

current resident or

Presort StandardUS Postage

PAIDPermit #14

Princeton, MN55371 President’s Pen . . . . . . . . . . . . . . . . . . . . . . . . . 1

Chapter Updates . . . . . . . . . . . . . . . . . . . . . . 3-5

Human Touch Collection: Empathy . . . . . . . . 5

Calendar of Events . . . . . . . . . . . . . . . . . . . . . . 6

Accent on Research: Data Bits . . . . . . . . . . . . 7

Unrecognized Epidemic Kills Farmers . . . . . 8

Personal Experience . . . . . . . . . . . . . . . . . . . . 10

KNA Education Summit . . . . . . . . . . . . . . . . . . 11

ANA News . . . . . . . . . . . . . . . . . . . . . . . . . . .12-14

Membership Application . . . . . . . . . . . . . . . . 13

KNA Centennial Video . . . . . . . . . . . . . . . . . . 14

The Human Touch Painting . . . . . . . . . . . . . . 15

The Off cial Publication of the Kentucky Nurses Association | Quarterly publication direct mailed to approximately 83,000 Registered Nurses & LPNs in Kentucky

INDEx

President’s Pen

Kathy Hager

Chapter UpdatespaGes 3-5

kna edUCation sUmmitpaGe 11

steppinG into a CUltUreof safety

paGe 12

SEE wHAT’S INSIDE

KENTUCKYA N AwA R D w I N N I N g P U B L I C AT I O N

NURSE Oct, Nov, Dec 2017 | Volume 65 | No. 4

Do you want to be part of something great?Let’s: • get nurses healthier and happier – and the people

for whom we provide care healthier and happier, too• support increasing the number of health-insured

Americans • work toward a more stable insurance market-place• preserve preventive care

Greetings, Kentucky Nurses:

With each newsletter, I try to remind myself of the goals KNA has established:

• Healthier and happier nurses• KNA an organization, of which all nurses feel honored to

be members• Governance by Chapters and Board of Directors• Membership growth, allowing more nursing presence

everywhere - on Boards, in health care organizational leadership, research participation, leading health promotion agendas

KNA has been very busy this year. As you know, there has been quite a lot going on in Kentucky and in the US over the past few months, related to health care. Kentucky is considering an 1115 waiver at this time; it proposes to expand Medicaid in a manner different from the Affordable Care Act’s (ACA, Obamacare) proposal. There are several features of the waiver to which KNA is opposed. We do not want people’s health care to be dependent on their providing community service. Despite the fact that we strongly recognize every American’s civic obligations, we do not want their healthcare hinging upon community service. Whatever innovative insurance waiver we propose, we want it to increase the number of people covered, making the care better and serving more people equitably. We want to expand Medicaid, so that people who are near the poverty level will receive assistance in getting insured; we believe health care is a right.

KNA has also been speaking out for improved health care at the national level as well. We support bipartisan review of the ACA care, with revisions as needed.

At the KNA office, much has been going on! Melissa Mershon, our interim ED, has been with us six months, and has been working tirelessly (with Lisa and Michelle – and many KNA members) on multiple projects:

• Hosting a Leadership Retreat (where Board directors, Cabinet and Committee members, and Chapter leaders) where KNA dreamed of where we are going

• KNA website

° an on-line calendar of events for KNA (including chapter meetings), for Kentucky Board of Nursing

events, for our sub-specialty group events, and for health advocacy programs (google Kentucky Nurses Association and look under Events in Kentucky) http://www.kentucky-nurses.org/Homepage-Category/Upcoming-Events/EVENTS-IN-OUR-STATE.html

° links to special services • Monthly e-newsletter-to highlight KNA events and

nurses• Nightingale tribute across the state – stay tuned for this

one – you will be proud of what Melissa has in mind in this area

• Delivering CPR manikins to all school districts who requested them – this was in support of CPR being taught at the high schools (long term project of past Governmental Affairs Chair, Shawn Nordheim)

• Reviving the Kentucky Nurses Foundation (with the help of Jo Singleton and the Board of Trustees)

• Coordinating the Summit in two locations (Louisville, Nov 2 / Teena Darnell, event planner; Lexington, Nov 3 / Carla Hamilton, event planner): Drowning in Substance Use, Focusing Upstream

• Re-writing a white paper on the use of medicinal marijuana, consistent with ANA’s white paper of 2016. We are pushing for marijuana to be rescheduled; once it is rescheduled in the US, research can be completed that will allow us to know its benefits and risks. KNA is co-sponsoring an event on medicinal marijuana. This event is in Louisville, September 29th, 2017, 8:30-4:05 pm.

Two KNA members were distinguished with the title of FAAN – Fellows of the Academy of Nursing. This honor is awarded to nursing leaders in education, management, practice and research. We are so proud of Kentucky’s newest members, Dr. Dorothy Brockopp and Dr. Sheila Melander. Congratulations to both of them.

President’s Pen continued on page 5

Page 2: KENTUCKY - d3ms3kxrsap50t.cloudfront.net€¦ · Lexington, KY 40503 E-mail: kendra_foreman@msn.com TREASURER: Nancy Garth, RN C: 859-312-0599 3292 Shoals Lake Drive H: 859-271-9529

Page 2 • Kentucky Nurse October, November, December 2017

Published by:Arthur L. Davis

Publishing Agency, Inc.

www.kentucky-nurses.org

“The purpose of the Kentucky Nurse shall be to convey information relevant to KNA members and the profession of nursing and practice of nursing in Kentucky.”Copyright #TX1-333-346

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]. KNA 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 Kentucky 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. KNA 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 KNA or those of the national or local associations.

The Kentucky Nurse is published quarterly every January, April, July and October by Arthur L. Davis Publishing Agency, Inc. for Kentucky Nurses Association, P.O. Box 2616, Louisville, KY 40201, a constituent member of the American Nurses Association. Subscriptions available at $18.00 per year. The KNA organization subscription rate will be $6.00 per year except for one free issue to be received at the KNA Annual Convention. Members of KNA receive the newsletter as part of their membership services. Any material appearing herein may be reprinted with permission of KNA. (For advertising information call 1-800-626-4081, [email protected].) 16mm microfilm, 35mm microfilm, 105mm microfiche and article copies are available through University Microfilms International, 300 North Zeeb Road, Ann Arbor, Michigan 48106.

EDITORIAL BOARD 2016 - 2017

EDITORS:Ida Slusher, PhD, RN, CNE (2016-2019)

MEMBERS:Patricia Calico, PhD, RN (2015-2018)

Sherill Cronin, PhD, RN-BC (2017-2020)Vickie Ann Miracle, RN, EdD, CCRC (2016-2019)

Kim Hawkins, PhD, APRN, CHSE (2017-2020)Cathy H. Abell, PhD, MSN, MS, RN, CNE (2016-2019)

REVIEWERS:Tiffany Cabibbo MSN, BSN, RN, CENP

Deborah Chilcote MSN, RNC, BADawn Garrett-Wright, PhD, RN

Elizabeth “Beth” Johnson, PhD, RNConnie Lamb, PhD, RN, CNE

KNA BOARD OF DIRECTORS

PRESIDENT: Kathy Hager, DNP, APRN, FNP-BC, CDE (2016–2018)

IMMEDIATE PAST PRESIDENT: Teresa H. Huber, DNP, MSN, RN (2014–2016)

VICE-PRESIDENT: Dana Todd, PhD, APRN (2015-2017)

SECRETARY: Beverly D. Rowland, PhD, RN, CNE (2015-2017)

TREASURER:Joe B. Middleton, DNP, APRN, NP-C, CEN, CC/NRP (2016-2018)

DIRECTORS-AT-LARGE:Teena L. Darnell, DNP, RN (2015–2017)

Dr. Michael Wayne Rager, PhD, DNP, MSN, FNP-BC, APRN (2015-2017)Liz Sturgeon, PhD, RN, CNE (2016-2018)

Kathy Mershon, RN, MSN, CNAA, ANEF, FAAN (2016-2018)

EDUCATION & RESEARCH CABINET:Judy Ponder, DNP, MSN, RN (2016-2018)

GOVERNMENTAL AFFAIRS CABINET:Amy Herrington, DNP, RN, CEN (2016-2018)

PROFESSIONAL NURSING PRACTICE & ADVOCACY CABINET:Karen Blythe, MSN, RN, NE-BC (2015-2017)

KNA CE Administrator: Judy Ponder, DNP, MSN, RN

KNF PRESIDENT: Jo Singleton, DNP, MSN, RN-BC

KANS Consultant: Christy Ralston, RN, BSN, CCMC

KNA STAFF

EXECUTIVE DIRECTOR: Delanor Manson, MA, BSN, RN

INTERIM EXECUTIVE DIRECTOR: Melissa Mershon

COMMUNICATION and MEMBERSHIP: Dionne Griffiths

ADMINISTRATIVE COORDINATOR: Lisa Snyder

KNA Chapter Leadership 2016-2017RIVER CITY CHAPTER (FORMERLY DISTRICT 1)CO-PRESIDENTS: Megan Carter, MSN , RN, PCCN-CMC, CNML (2016-2018) P: 972-989-5705 W: 502-897-8373 4612 Miller Glen Pl. Louisville, KY 40068 Email: [email protected]

Christy Ralston, RN, BSN, CCMC P: 502-386-7261 W: 502-629-3617 4300 Forest Bend PL Louisville, KY 40245 E-mail: [email protected]

TREASURER: Emily Coxon, BSN, RN

SECRETARY: Heather Dunn, BSN, RN, PCCN P: 618-263-2166 3209 Sudbury Lane Louisville, KY 40220 E-Mail: [email protected]

EVENT PLANNER: Renee Cecil, RN, BSN, CEN, CCCC, SANE, NREMT P: 502-544-5589 Norton Audubon Hospital Emergency Department Nurse Manager E-Mail: [email protected]

BLUEGRASS CHAPTER (FORMERLY CHAPTER 2)PRESIDENT: Ida Slusher, PhD, RN 231 Churchill Xing Nicholasville, KY 40356 E-Mail: [email protected]

SECOND VICE-PRESIDENT : Kendra Foreman, MSN, RN 859-550-3491 571 Longview Dr. Lexington, KY 40503 E-mail: [email protected]

TREASURER: Nancy Garth, RN C: 859-312-0599 3292 Shoals Lake Drive H: 859-271-9529 Lexington, KY 40515 W: 859-323-0733

NORTHERN KENTUCKY CHAPTER (FORMERLY DISTRICT 3)PRESIDENT: Teresa Williams, MSN, RN, NE-BC H: 859-384-7170 10019 Golden Pond Dr. Union, KY 41091 E-Mail: [email protected]

TREASURER: Mary A. Crowell H: 859-727-4340 3504 Susan Lewis Dr W: 859-371-9393 Erlanger, KY 41018

SECRETARY: Monica Meier, MSN, RN, AHN-BC 859-620-4464 625 Brandtly Ridge Dr. Covington, KY 41015-4227 E-Mail: [email protected]

HEARTLAND CHAPTER (FORMERLY DISTRICT 4)PRESIDENT: Janice Elder, MSN, RN H: 270-756-6415 PO Box 834 Hardinsburg, KY 40143 E-Mail: [email protected]

TREASURER: Susan E. Nesmith, APRN, RN H: 270-300-4062 1623 Hutcherson Lane W: 270-706-1683 Elizabethtown, KY 42701-8977

SECRETARY : Anne Sahingoz, MSN, RN H : 502-549-3028 239 Ridgeview Dr. New Haven, KY 40051 E-Mail: [email protected] [email protected]

WEST KENTUCKY CHAPTER (FORMERLY DISTRICT 5)PRESIDENT: Nancy Armstrong, MSN, RN H: 270-435-4466 1881 Furches Trail W: 270-809-4576 Murray, KY 42071 E-Mail: [email protected]

TREASURER: Katy Garth, PhD, RN H: 270-435-4544 358 Butterworth Road W: 270-762-6669 Murray, KY 42071

KENTUCKY NURSES REACH - RESEARCH, EDUCATE, ADVOCATE, CARE, HELP (FORMERLY DISTRICT 7)PRESIDENT: Kim Bourne, PhD(c), MSN, C: 270-404-6189 RN, SANE, CNE O: 270-745-3052 147 Bulldog Road Glasgow, KY 42141-8845 E-Mail: [email protected]

TREASURER: Carol Evans, H: 270-526-3450 230 Otis Embry Rd O: 270-745-4589 Morgantown, KY 42261

SECRETARY : Dawn Garrett-Wright, PhD, MSN, RN 1819 Smallhouse Rd. O: 270-745-3800 Bowling Green, KY 42104 E-Mail: [email protected]

GREEN RIVER CHAPTER (FORMERLY DISTRICT 8)PRESIDENT: Amy Wimsatt H: 270-316-4262 6789 Kingston Dr. Owensboro, KY 42303 E-Mail: [email protected]

TREASURER: Carol Murch, MSN, RNAPRN H: 270-521-9980 18143 Upper Delaware Road W: 270-831-9787 Henderson, KY 42420

SECRETARY: Marlena Buchanan E-Mail: [email protected]

NIGHTINGALE CHAPTER (FORMERLY DISTRICT 9)PRESIDENT: Patricia Calico, PhD, RN (Interim President) 85 Henry Clay Rd Stanford, KY 40484 E-Mail: [email protected] Phone: 606-669-3638

TREASURER: Charlene Maddox, BSN, RN H: 859-236-6336 PO Box 2055 Danville, KY 40423

SECRETARY : Denise Alvey, MSN, RN-BC 502-353-4223 1009 Bunker Hill Dr. Lawrenceburg, KY 40342 E-Mail: [email protected]

NORTHEASTERN CHAPTER (FORMERLY DISTRICT 10)PRESIDENT: Christa Thompson MSN, RN-BC W : 606-783-5370 Morehead State University Department of Nursing CHER 201 HH 316 W 2nd Street Morehead, Kentucky 40351 E-Mail: [email protected]

TREASURER: Phelan Bailey, BSN, RN, CEN, CPEN W: 606-356-8158 404 Jewell Ln Morehead, KY 40351-8842

SCHOOL NURSES IN EVERY KENTUCKY SCHOOL CHAPTERCO-PRESIDENTS: Mary Burch, RN, ADN P:859-341-8337 340 Creekwood Dr Edgewood, KY 41017 E-mail: [email protected]

Eva Stone, MSN, APRN P: 859-583-5078 106 Hubble Rd Danville, KY 40422 E-mail: [email protected]

SECRETARY & TREASURER: Lois Davis P: 859-296-0252 3140 Blenheim Way Lexington, KY 40503

EX OFFICIO MEMBER FOR ALL KNA CHAPTERS Kathy Hager, DNP, APRN, FNP-BC, CDE (2016-2018) W: 502-272-8103 1508 Main Street C: 502-682-0651 Shelbyville, KY 40065 Bellarmine University E-Mail: [email protected]

Page 3: KENTUCKY - d3ms3kxrsap50t.cloudfront.net€¦ · Lexington, KY 40503 E-mail: kendra_foreman@msn.com TREASURER: Nancy Garth, RN C: 859-312-0599 3292 Shoals Lake Drive H: 859-271-9529

October, November, December 2017 Kentucky Nurse • Page 3

KNA BLUEGRASS CHAPTERMay Member Meeting 2017: • The Karen Tufts Award recipient was announced. The

recipient is Kristie Stambaugh, a graduating nursing student from Midway University. This award includes a one year ANA/KNA membership and a $100 monetary gift. The award will be presented to her at the September member meeting, as she could not attend in May.

• Laura Riddle brought attention to the ZIKA virus issue in the nation & potential issues within our state that she became aware of during a recent attendance of a state conference. She noted that local health departments will soon be rolling out a plan for dealing with this issue.

• Michelle Malicote, BSN, RN, Manager School Health Clinic Services within the Madison County school system presented a lively discussion about the role of the school nurse in Madison County.

June Board Meeting 2017:• Members of the BOD are personally contacting

KNA Bluegrass Chapter members whose ANA/KNA membership is about to expire and encouraging them to renew their membership.

• The BOD approved the current ballot for the upcoming election of board and Nominating Committee openings. After the election results are in (ballots will be distributed electronically, primarily, and by mail, as needed, in July/August), the newly elected officers and Nominating Committee members will be inducted at the September membership meeting.

July Member Meeting 2017:• Ida Slusher asked for any volunteers to take on the role

of treasurer until the upcoming election due to the resignation of the current treasurer. Ballot Nominees for treasurer are also encouraged to come forward.

• Ida Slusher noted that volunteers have come forward to be on the Chapter Finance Committee that will be responsible for developing potential annual budget for the BG Chapter. However, the group has not had the opportunity to meet. If the group does not meet prior to the August 2017 Board meeting, the Board meeting will be reserved to include the development of a tentative budget to be presented at the September Member meeting.

• Ida Slusher shared with the group that there are subject experts for speaking engagements that could be invited as Guest Speaker’s for future Member meetings such as speakers for Human Trafficking, Nurse Advocacy, and Substance Use Disorders. Jackie Graves has been asked to contact the state office and arrange for these speakers to present these topics as Guest Speakers at upcoming member meetings.

• Carol Komara shared with the members that the Selection of officers/Board will be electronic this year. Voting should take place sometime in August with recognition of elected officers/Board in September.

• Carol Komara gave a follow up regarding initiatives at the state-level regarding school nurses. Groups have met with key state legislators and attended meetings

Chapter Updatesof the Health & Welfare Committee. She encourages all KNA members to continue to advocate for school nurses as the evidence is clear there is a positive outcome for students who have nurses available at the schools.

• Lynn Roser shared that she has had discussions with local/regional hospital nursing staff who have voiced their concern regarding the preparation of new nurse graduates on infection control practices. An open discussion was held that focused on what concepts are important for nursing students to receive during their nursing education to improve their readiness and knowledge of promoting adequate infection control practices. Lynn also shared that there are state-employed Infection Preventionists who would be willing to work with students & others to improve understanding and knowledge of infection prevention.

• Jennifer Parr, DNP, PMHNP-BC, gave an outstanding presentation on “Substance Use Disorders.” Symptoms due to use of various substances and assessment parameters for each were discussed.

HEARTLAND CHAPTER:The Heartland Chapter has been in contact with the Feed

America program, whose regional operations are based in Elizabethtown. This program provides services to 42 counties in the southern part of KY. We will be providing some much needed volunteer hours in order to help the elderly with the senior meal boxes and school children who are in the backpack program.

Another planned event will be a continuing education program in partnership with Twin Lakes Regional Medical Center, in Leitchfield, KY, on legislative/nursing advocacy topics. This is tentatively planned for October 11, 2017 at the time of this notice.

We want to remind all Heartland Chapter members that we are holding all of our quarterly meetings at Hardin Memorial Hospital, third floor conference room. The next meeting is scheduled for November 16, 2017 at 6:00 pm EST. If you are not able to physically attend the meetings, please join us via conference call or web-conferencing.

For more information or if interested in joining the chapter, please email us at [email protected], visit us at http://annesahingoz.wixsite.com/knaheartland, or contact Chapter President, Janice Elder at: 270-756-6415 or [email protected] or [email protected]

Chapter Updates continued on page 4

Information for Authors• Kentucky Nurse Editorial Board welcomes submission

articles to be reviewed and considered for publication in Kentucky Nurse.

• Articles may be submitted in one of three categories:

° Personal opinion/experience, anecdotal (Editorial Review)

° Research/scholarship/clinical/professional issue (Classic Peer Review)

° Research Review (Editorial Review)• Information about IRB or Ethical Board approval is a

requirement for Quality Improvement projects, evidence practice based projects, and research studies.

• All articles, except research abstracts, must be accompanied by a signed Kentucky Nurse transfer of copyright form (available from KNA office or on website www.Kentucky-Nurses.org) when submitted for review.

• Articles will be reviewed only if accompanied by the signed transfer of copyright form and will be considered for publication on condi tion that they are submitted solely to the Kentucky Nurse.

• Articles should be typewritten with double spacing on one side of 8 1/2 x 11 inch white paper and submitted in triplicate. Maximum length is five (5) typewritten pages.

• Articles should also be submitted electronically• Articles should include a cover page with the author’s

name(s), title(s), affiliation(s), and complete address.• Style must conform to the Publication Manual of the

APA, 6th edi tion.• Monetary payment is not provided for articles.• Receipt of articles will be acknowledged by email to the

author(s). Following review, the author(s) will be notified of acceptance or re jection.

• The Kentucky Nurse editors reserve the right to make final editorial changes to meet publication deadlines.

• Please complete a manuscript checklist to ensure all requirements are met. You must provide a completed checklist when a manuscript is submitted. The Manuscript Checklist can be found at www.kentucky-nurses.org.

• Articles should be mailed, faxed or emailed to:

Editor, Kentucky Nurse, Kentucky Nurses Association, 305 Townepark Circle, Suite 100, Louisville, KY 40243

(502) 245-2843 • Fax (502) 245-2844 • or email: [email protected]

QA Nurse, LPNs, KMAs, SRNAs needed.

Sign on bonus for full time. 12 and 8 hour shifts available.

39 Ferndale apts. rd pineville, KY 40977 606-337-7071

www.mountainviewnursingcenter.com

Page 4: KENTUCKY - d3ms3kxrsap50t.cloudfront.net€¦ · Lexington, KY 40503 E-mail: kendra_foreman@msn.com TREASURER: Nancy Garth, RN C: 859-312-0599 3292 Shoals Lake Drive H: 859-271-9529

Page 4 • Kentucky Nurse October, November, December 2017

NIGHTINGALE CHAPTER:• At our August meeting, Rosie Albright presented a

1 hr CE on “Suicide Assessment.” Brittany Pridey was presented a $500 scholarship. Brittany is in the BSN program at Kentucky Christian University.

• A $500 scholarship will be available for the 2018 spring semester and will be presented at the May chapter meeting. Deadline for submission of an application is April 27, 2018. For details contact Denise Alvey at [email protected].

• 2018 meetings will be March 8 & May 10 at Ephraim McDowell Regional Medical Center at 6:30 pm. Sheila Schuster, KNA lobbyist, will be speaking on legislative issues at the March meeting.

From left to right is: Pat Calico, interim chair, Nightingale chapter, Karen Pridey (scholarship

winner’s mother), Brittany Pridey, our fall scholarship winner, and Denise Alvey.

Kathy Hager and Megan Carter

NORTHEASTERN CHAPTER:The purpose of the chapter is to improve health for the

communities we serve and inspire nurses to achieve nursing excellence. We are devoted to high quality patient care, patient safety, evidence-based practice and advancing community health.

Our chapter has been active in teaching community members BLS for free as part of a grant awarded to chapter earlier in the year. The next meeting is scheduled on September 26, 2017 at the Center for Health, Education, and Research (CHER) 102 D in Morehead, Kentucky. We’re scheduled to have Dr. Kathy Hager and Dr. Shelia Schuster at the meeting. Dr. Schuster, KNA lobbyist, will be presenting on nursing advocacy. The meeting begins at 5:00 p.m. with the CNE event starting at 5:30 p.m.

For more information please contact chapter President, Christa Thompson, at [email protected] or 606-783-5370.

NORTHERN KENTUCKY CHAPTER:At our June meeting, Linda Robinson presented “Violent

Emergency Department Sparks House-wide and Legislative Change.” 1.2 free contact hours were awarded to participants. We are excited to offer another free offering on September 13th. “Autism and Healthcare: Strangers in a Strange Land,” will be presented by Mary Price, MSN, RN-BC, NE-BC. For additional information, please contact Teresa Williams, MSN, RN, NE-BC at [email protected]

KNA RIVER CITY CHAPTERThe River City chapter has been hosting some great events

to promote networking and advocacy. On July 20th, we hosted a Nurses’ Night event at Louisville

Slugger Field and gave away the new River City shirts. We had around 30 nurses throughout the evening (see attached pictures)

On July 26th, we hosted “Nursing Advocacy: Your Voice Counts” at Bellarmine. Sheila Schuster, PhD was our keynote speaker. We had close to 40 attendees and learned about the current legislative session as it relates to nursing care. Attendees earned 1.8 CEs and signed up to join the chapter (see attached pictures). Those who attended were ready to talk to their legislators and advocate for their patients/communities!

Our Member Meetings will continue to be the fourth Thursday of the odd months at 1730 EST. We meet at the KNA Office in Middletown and also offer a conference call option. Dates will be 9/28, 11/23, 1/25.

Our future events focus include wellness events in the greater Louisville area for nurses to support the Healthy Nurse/Healty Nation objective. We are also looking at community service opportunities to share with the membership. More to come!

PICTURES FROM KNA RIVER CITY CHAPTER Nurses’ Night at Slugger Field on July 20th.

PICTURES FROM KNA RIVER CITY 7/26/17 event: Nursing Advocacy: Your Voice Counts!

Chapter Updates continued from page 3

Chapter Updates continued on page 5

Kathy Hager Sheila A. Schuster, PhD., Licensed

Psychologist, Lobbyist for KNA

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October, November, December 2017 Kentucky Nurse • Page 5

School Nurses in Every Kentucky School Chapter:The summer has been a busy time for the School Nurses

in Every KY school chapter of KNA. In May, there was a chapter meeting in Lexington. Two days later the executive committee met with Dr. Sheila Schuster to discuss a legislative plan moving forward. In June, Carol Komara, Mary Burch, Kathy Hager, Teena Darnell and Lois Davis attended the legislative Health and Family Services Committee meeting. Meetings were scheduled with multiple legislators who discussed the need for school nurses and the need for legislation to place nurses in schools. Drs. Schuster and Hager spent the afternoon meeting with Representatives Adia Wuchner, Laura Arnold (KDE Associate Commissioner Office of Career and Technical Education) and others to discuss multiple nursing initiatives.

Following those meetings, the executive committee drafted a letter for Education Commissioner Pruitt and other key officials, discussing the need for an RN in every school and the work of the chapter. The group asked that the presence of school nurses be considered a factor in measuring school accountability for KY. Dr. Pruitt sent a response to the group stating that the KY Department of Education supports having school nurses but cited funding concerns. He mentioned that School Nurses are included as part of Kentucky’s proposed school/district accountability model.

A review of the proposed model showed that school nursing is one of many positions from which districts may choose to receive points toward meeting student health needs. In response, the workgroup sent an email to Commissioner Pruitt and all state board of education members, asking them to include nurses as a separate measure, rather than including them with multiple staff choices.

On August 2nd, the state Board of Education met in Frankfort; Kathy Hager, Teena Darnell, Lois Davis and Carol Komara listened to presentations regarding the new model. On August 3rd, public comments were allowed; Carol Komara and Eva Stone addressed state Board members, asking them to consider the impact school nurses can have on improving school attendance, thus promoting positive educational outcomes. The state board was urged to consider the presence of full-time school nurses as a separate measure for school accountability.

On August 14, Kathy Hager attended the legislative education committee meeting where student absenteeism was discussed. She had the opportunity to speak to several key stakeholders on this committee, regarding the school nurse initiative. She distributed flyers to those in attendance about the benefit of providing nursing services for children in public schools.

We welcome any interested nurses who want to be part of this mission. There is much work to be done as we plan to introduce legislation for school nurses in the state. If you would like to be part of this workgroup please contact Mary Burch ([email protected]) or Eva Stone ([email protected]) and you can be added to the distribution list.

This is an issue where everyone can help. The more voices sounding the message, the more we can be heard and impact the health of children in KY.

The Kentucky Nurses Association wants to send a big thank you to our KNA members that volunteered to help us go green!

Re’Nee CecilTracy Jenkins

Julie JoinerChrista Thompson

Teresa Villaran

These volunteers made phone calls to KNA members that don’t have a current e-mail address on file. Thank you so much for taking the time and helping out! If you are a member and need to update an email address, please email [email protected] or call the KNA office at 502-245-2843

Thank You!

Chapter Updates continued from page 4 President’s Pen continued from page 1

The Kentucky Board of Nursing (KBN) may be restructuring, according to Governor Matt Bevin’s executive order. A meeting was held for major nursing groups, where the Secretary of the Public Protection Cabinet David Dickerson announced that all Boards would be restructured. It was originally slated to occur July 1; apparently, there are continued revisions, as there is no official effective date for the order. The KBN’s Board will be reduced to 13 (from 16); the last report was that the KBN Executive Director Paula Schenk would not retain her position. KNA will be sending updates regarding the KBN.

KNA nominates nurses to several governmental board positions; KNA usually sends two names of nurses in specific roles of direct care, administration and education.

From the Governor’s press release: Teresa Huber was appointed by Gov. Bevin to the KBN and shall serve for a term expiring June 30, 2020; Gail Wise and Dina Byers were re-appointed to the KBN and shall serve for a term expiring June 30, 2020.

KNA is offering continuing education events related to the identified focus areas which the Ethics and Human Rights’ Committee identified: “Human Trafficking and Substance Use Disorder.” Marissa Castellenos of the Catholic Charities of Louisville will be presenting human trafficking programs at the chapter level. Substance Use Disorder (SUD) is the Summit’s Focus (above), as well as programs across the state, at the chapter level. Dr. Sheila Schuster, our lobbyist, will also be presenting a nursing advocacy / policy update; her program has already been approved for continuing education – her first presentation was to the River City Chapter. Chapters across the state can simply set up dates with Dr. Schuster.

The Governmental Affairs (GA) Committee had a mini-retreat in Frankfort July 12, 2017, from 4-8pm. The group had general conversation about the importance of KNA’s presence at health care events and KNA’s involvement in the Kentucky Center for Nursing. KNA is successfully acting as the umbrella for sub-specialty organizations, and is proud to be posting their events and initiatives on the KNA website. When organizations have asked us to support their policy agenda, the GA Committee has been challenged to be able to support action items in a timely manner. The GA group has devised a form that will allow each group to succinctly describe their initiative and the needed action item. Dr. Schuster and the GA Committee will work to report to all of the KNA members on which bills we support, monitor or oppose. There will be a KNA 2018 Legislative Day in Frankfort, Feb 4th, 2018. Details will be sent to the membership.

The Nominating Committee has been working with Lisa at the KNA Office. What a great slate we have! KNA staff and members appreciate the dedication of each of those that have served, or are offering to serve.

May the fall season bring much joy and good health to each of you! Don’t forget to tell us what you need from KNA. We really will listen to you!

KNA members:

It is with both regret and celebration that I write this note to inform you that as of September 5th, KNA has a new Executive

Director, Ms. Delanor Manson, RN, MA! Ms Manson served our country, in the Navy, for 27 years. This in itself speaks to her integrity! She also worked in leadership for Hosparus. To balance her work life, she owns an art gallery. Her work history is impressive and so is she! We welcome her and look forward to actualizing her visions of making KNA a ‘super power,’ working for and with Kentucky nurses.

The Board of Directors interviewed several people for this position and were thrilled to offer the position to Ms Manson. We have all celebrated her acceptance!

As you know, Ms. Melissa Mershon has been our interim ED for over eight months; Melissa told us when she joined us at KNA, that she would ultimately want a position in the pension system, as she had a long history of public service to Louisville and the Commonwealth. It would be impossible to list the many contributions Melissa has made to KNA…from her creativity; to her organizational skills; to her mastery with agendas, timelines, and compliance with non-profit entities; and to her dream for how great KNA can be. The list of accomplishments is long and productive; it is inconceivable that she accomplished so much in less than a year. Melissa has agreed to work with Delanor as we transition from one great leader to another. Quoting Shakespeare, ‘parting is such sweet sorrow.’ We wish both of them the very best as they continue to serve Kentucky.

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Page 6 • Kentucky Nurse October, November, December 2017

October 2017

12 KNA Nightingale Chapter Meeting, 6:30 PM, Ephraim McDowell Hospital, McDowell room, Danville, Kentucky 19 KYANNA Black Nurses Association Meeting, 5:30 PM, Conference Room, Norton Healthcare Medical Towers South, Louisville, Kentucky

19-20 KBN Meeting 25 KNA Education & Research Cabinet Meeting, 4:00 PM–5:00 PM, Conference Call 26 Kentucky Center for Nursing Meeting

November 2017

2 KNA Summit Annual Meeting – Louisville** 3 KNA Summit Annual Meeting – Lexington** 14 KNA REACH Chapter- 5:00 PM- 7:00 PM CST; Greenview Regional Hospital, Bowling Green. Will be collecting Toys for Tots 14 Advocacy Training: Nursing Advocacy: Your Voice Counts!; U.K. Time: TBD 15 KNA Northern KY Chapter: Nursing Advocacy: Your Voice Counts!; St. Elizabeth Training & Education Center; Erlanger, KY 16 KYANNA Black Nurses Association Meeting, 5:30 PM, Conference Room, Norton Healthcare Medical Towers South, Louisville, Kentucky 16 KNA Heartland Chapter Meeting; 6:00 PM EST; Hardin Memorial Hospital, 3rd floor classroom 17 9:00 AM Kentucky Board of Nursing Committee Meeting 21 KNA Bluegrass Chapter Meeting, 5:30 PM (Social time)/6:00 PM (Meeting time) Chop House on Richmond Road, Lexington, KY 30 KNA River City Chapter Meeting, 5:30 PM EST, KNA Office

December 2017

1 KNA Leadership Retreat. Location: My Old Kentucky Home 7 10:30 AM-3:30 PM Kentucky Board of Nursing Meeting 8 KNA Ethics and Human Rights Committee Meeting- 2:00 PM- 4:00 PM, Bellarmine University Miles Hall Room 304 21 KYANNA Black Nurses Association Meeting, 5:30 PM, Conference Room, Norton Healthcare Medical Towers South, Louisville, Kentucky 27 KNA Education & Research Cabinet Meeting, 4:00 PM–5:00 PM, Conference Call

January 2018

16 KNA Bluegrass Chapter- 6:30 PM-8:00 PM, Chop House Lexington, KY; Nursing Advocacy: Your Voice Counts! 25 KNA River City Chapter Meeting, 5:30 PM EST, KNA Office

February 2018

6 KNA Day at the Capitol, 2018 KNA Legislative Day at the Capitol, 9 AM - 2 PM, 11AM- Noon - Rally in the Rotunda

13 (tentative): KNA REACH Chapter- 5:00 PM-7:00 PM CST; WKU/Medical Center Health Sciences Complex, Bowling Green. Will be collecting for Foster Care.

March 2018

1 Call for KBN Nominations due to KNA office 8 KNA Nightingale Chapter Meeting, 6:30 PM Nursing Advocacy: Your Voice Counts! McDowell Room, Ephraim McDowell Hospital, 213 South Third Streed Danville, KY 40422

April 2018

1 Call for November 2018 Elections Nominations due to KNA office 16-21 Kentucky Coalition of Nurse Practitioners & Nurse Midwives Annual Conference, Lexington, KY 17 (tentative): KNA REACH Chapter- 5:00 PM-7:00 PM CST; WKU/Medical Center Health Sciences Complex, Bowling Green. Will be collecting for the Center for Courageous Kids.

November 2018

1-2 KNA Annual Conference, Holiday Inn Louisville East

April 2019

22-27 Kentucky Coalition of Nurse Practitioners & Nurse Midwives Annual Conference, Covington, KY

November 2019

8 KNA Education Summit, Four Points by Sheraton Lexington

November 2020

5-6 KNA Annual Conference, Holiday Inn Louisville East

November 2021

5 KNA Education Summit, Four Points by Sheraton Lexington

KNA Governmental Affairs Cabinet: First Monday of every Month, 11:30 am-12:30 pm, conference call

KNA Board of Directors Meeting: First Friday of the Month

KNA Chapter Leadership Conference Call Meetings:Third Monday of every month, 1:30 PM EST

Kentucky Nurses Foundation Board of Trustee Meetings:Fourth Tuesday of every month at the KNA office, 12:00 – 4:00 PM

***All nurses are welcome to attend any nursing event.

These are open to KNA members and non-members***

**You are not required to attend both KNA Summit dates, just one that fits your location and time best.

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October, November, December 2017 Kentucky Nurse • Page 7

Linda Mcauley, Abby Schlaug, Emily Ackemann, BSN students at Bellarmine University

In 2001, the Institute of Medicine (IOM) reported that there are approximately 98,000 patient deaths each year due to medical errors. Medication administration errors (MAE) are the third leading cause of sentinel events (The Joint Commission, 2015). Distractions while completing medication administration have been linked to MAEs.

Nurse researchers recently conducted a study to evaluate a novel approach – a noise-reducing headset – to reducing noise distractions during medication administrations. The questions addressed are: (a) Does wearing a headset decrease the frequency of errors made by the nurse during medication access? (b) Does the headset work as a cue to prevent other staff members from approaching the nurse, thus distracting her? (c) What attitudes do the staff hold regarding distractions and the use of a headset?

A quasiexperimental study was performed on three units in a teaching hospital in the southeast United States. These units had centrally located medication access stations close to the nursing stations; and each of the medication access stations used signage emphasizing No Interruption Zones (NIZ). One hundred seven nurses participated in the study. They were first observed by the researchers for two months regarding distracted behavior and the potential for distractions. These distractions were measured using an observation tool created by the researchers. The participants were then given a pre-intervention survey regarding their attitudes and beliefs about distractions. Once the participants were trained on the use of the headset, the researchers observed the participants for another two months, measuring their behavior using the same scale as in the pre-intervention phase. At the completion of the two months, the participants were given a post-intervention survey.

The survey data suggested that nurses did not believe that they experienced distractions during medication access. However, the 206 total observations suggested otherwise. In the pre-intervention phase, there were 149 total observations. The researchers recorded 125 (83.9%) potential distractions, 40 (39%) of which were intentional potential distractions. During these

Tuning Out the Distractionsdistractions, the RN became visibly distracted 62 times (49.6%). In the post-intervention phase, there were 57 total observations, with 52 (91.2%) potential distractions; 11 (21%) of which were intentional. However, the RN only became visibly distracted 10 (19.23%) times. While there was not a statistically significant difference in intentional distractions between the pre-intervention and post-intervention phases (p = 0.14), there was a statistically significant decrease in the nurses’ visible distractedness between the pre-intervention and post-intervention phases (p = 0.001). The nurses were less visibly distracted when wearing the headset.

This study demonstrated the high frequency of distractions that nurses experience while preparing for medication administration. This is the first study that used an active approach to reducing distractions at medication access stations using a headset. The findings suggest that this method could prevent nurses from becoming distracted, thus potentially reducing the number of medication errors. Further research is recommended to understand how headsets could discourage interruptions to the nurse by providing a cue to others that the nurse is preparing medication. The presence of a headset promotes the physical appearance of isolation as well as promoting an active approach to isolate the nurse from distracting stimuli. The current study was unable to statistically compare the intentional distractions due to the small sample sizes. The researchers also suggested moving the medication access areas away from the nurse’s station and emphasize the importance of distraction free zones to further promote this isolation.

Sources: Wolak, E., Hill, A., Ball, P. & Culp, L. (2017) A novel approach to reducing RN distraction during medication

access. Medsurg Nursing, 26, 93-98.The Joint Commission. (2015) Sentinel event data-root cause by event type (2004-2014). Oakbrook Terrace, IL: Author

Data Bits is a regular feature of Kentucky Nurse. Sherill Nones Cronin, PhD, RN-BC is the editor of the Accent on Research column and welcomes manuscripts for publication consideration. Manuscripts for this column may be submitted directly to her at: Bellarmine University, 2001 Newburg Rd., Louisville, KY 40205.

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Page 8 • Kentucky Nurse October, November, December 2017

M. Susan Jones, PhD, RN, CNE, ANEFDeborah B. Reed, PhD, MSPH, RN, FAAOHN, FAAN

Matthew L. Hunt, EdD Western Kentucky University

Institute for Rural HealthCollege of Health and Human Services

Bowling Green, KY

Imagine a job that you never leave day after day and year after year. Your home, your family, your finances, and your future are all tied up in the land beneath your feet. Perhaps your grandparents or even great-grandparents lived and worked on the same land. Now imagine getting only two or three paychecks each year from your production on that land. Finally, imagine running your business each year dependent on a new bank loan. Your imagination just described the modern day family farming operation; the type of farming that makes up 95% of Kentucky’s 78,000-plus farms, a multi-billion dollar industry in the Commonwealth. The purpose of this paper is to raise nurses’ awareness of stress and depression among farmers and their family members, to present factors that may influence stress, depression, and suicide, and to identify possible resources for nursing practice.

Sources and Manifestations of StressMuch research has been conducted on the effects and the role of “job control” to

alleviate occupational stress. However, the environment of production agriculture boasts little control. Instead, control is passed to nature – too much or too little rain or winds can destroy a crop, insect infestation or crop disease can destroy a year’s work overnight, an injury to the primary farmer places him or her on the sidelines with no one to complete the essential tasks on the farm. Farmers are also faced with additional uncontrollable factors such as fluctuating market prices, changing governmental regulations, and a shrinking labor force. Without question, farming is recognized as a stressful occupation. Untreated stress can lead to anxiety, depression, and chemical dependence. Sometimes farming becomes so stressful that individuals commit suicide rather than leave the occupation.

Epidemic: What is the Evidence?Mental health issues associated with farming have been widely discussed in the

literature over the years (Booth, Briscoe, & Powell, 2000; Boxer, Burnett, & Swanson, 1995; Browning, Westneat, & McKnight, 2008; Donham & Thelin, 2006; Fraser et al., 2005; Grisso et al., 2008; Milner, Spittal, Pirkis, & La Montagne, 2013; Rossman, 2008; Stallones, 1990), yet there has been no change in the ranking of occupations with the highest suicide

occurrence. Browning et al. (2008) examined suicide among farmers in Kentucky and North Carolina as reported by death certificate. Browning et al. (2008) found that suicide occurrence was highest at each end of the age spectrum, with the greatest risk above age 75. Although the actual mortality rate was slightly smaller than that reported for Kentucky farmers by Stallones (1990), rates were still well above the average for males in Kentucky. The suicide rate by occupational groups in 17 states was recently reported to be the highest (84.5 per 100,000) among the farming, fishing, and forestry group (McIntosh et al., 2016). A current Kentucky report documented 302 farmer suicides between 1998-2016 (occupational data were not collected in 2007-09) with 100 of those between 2010-2016 (KY Injury Prevention Research Center, personal communication, January 26, 2017). The latest report by the KY Injury Prevention Center illustrates that the burden of suicide has not lessened. There are no data on the number of failed suicide attempts, thus the little that is known is merely a glimpse at the underlying epidemic.

Cultural and Rurality InfluenceSuicide occurs at a greater rate in rural compared to urban areas and the gap is widening

(Scott, Stone, & Holland, 2017). A recent review of rural suicide literature suggests that risk factors must be viewed from an ecologic perspective (Hirsch & Cukrowicz, 2014). This lens fits well when positioned with farmers. The farmer may have individual characteristics that predisposition him/her to be unable to cope. There may be genetic predisposition to psychiatric illness or the farmer may not be able to physically perform the farm work anymore. Reed, Rayens, Conley, Westneat, and Adkins (2012) reported that for 40% of farmers age 50 and over the ability to work became their definition of health and the percentage rose with advancing age. The family unit may be under stress from a variety of factors, including multigenerational work or no one in the family to carry on the tradition of farming. The results of this stress is particularly salient for the eldest farmers for whom the land is precious (Maciuba, Westneat, & Reed, 2013). Conversely, younger farmers may feel intense pressure to live up to the standards set by the previous generation on the farm. Individual and family characteristics of the farmer’s health and their impact on psychological health have received little attention.

The rural community itself can be a formidable obstacle to the good mental health of the farmer. While rural communities are by and large safe and supportive, there is a growing infiltration of large corporate businesses that may not be as amenable to extending loans in lean times as did the locally owned bank or carrying credit on farm supplies over a longer

Unrecognized Epidemic Kills Farmers

Please join us for the KNA-Sponsored Nurses Day at the Capitol on Tuesday, February 6th, 2018. We will have a Rally in the Capitol Rotunda from 11:00 a.m. – Noon EST with activities before and after. More details will be shared in the near future.

Also, in preparation for the event and our roles as advocates, our lobbyist Sheila Schuster will be conducting several advocacy training programs in communities across the state. We anticipate more dates/locations will be added to the calendar soon.

DATE/TIME

CHAPTER LOCATION CONTACT# OF

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9/26/17 5:00 pm

Northeast Chapter

St. Claire Medical Center - Morehead

Christa Thompson [email protected]

1.8

11/14/17 KNAUniversity of

[email protected] 1.8

11/15/17 5:00 pm

Northern KY St. E’s, ErlangerTeresa Williams

[email protected]

3/8/18 Nightingale Danville Pat Calico [email protected] 1.2

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October, November, December 2017 Kentucky Nurse • Page 9time period. If farmers find themselves despondent or depressed they may not have ready access to appropriately trained mental health professionals. Also, the stigma of mental health issues continues in rural communities. Farmers may actually be fearful of a visit to a mental health facility getting back to the loan officer or other powerful farm community members.

Agriculture once moved at the pace of nature, but now it has become a global industry, bobbing and weaving to international policies and markets. Environmental and animal protection groups hold farmers more accountable in their practices which creates more documentation by the farmer. The constant “ag banging” by some factions of these groups creates angst among farmers who value and protect their land and animals. Stress comes from all directions and farmers can do little to combat it. In recent years the economic downturn of agriculture has left farmers wondering if they can hold on until the next year and will the next year be better or worse? Some farmers elect to participate in the federal crop insurance program, a safety net that hopefully will prevent financial devastation. While other businesses may be able to sell off part of their holdings, farmers cannot sell the land or their equipment and they are expected to be productive.

The physical isolation of the farm and the farmer may also play into depression and suicide. Prolonged alone time on a combine harvesting a crop that you know will not get you out of debt can be a powerful influence. As the attachment to the land becomes more powerful the troubled farmer may see suicide as the only way to save the land. The misguided image of the insurance paying off the farm may become a picture of reality to the farmer. Farmers deal with life and death regularly, they have the means to complete the act. A tractor overturn, a fall from a silo, or a rifle are all at their disposal.

What Can We Do as Nurses?Despite this grim portrait, nurses are in positions to assist

these farmers. It starts by simply asking if the person resides in a farm household and, if so, what role does she or he play in the farm enterprise. A follow up question asking, “How are things on your farm?” may give the farmer permission to outline emotions. Mental health screening is becoming standard practice in many clinics. The Patient Health Questionnaire 9 (PHQ-9) is a quick, reliable tool to use to assess and manage depression (Blackwell & McDermott, 2015).

Many nurses in rural communities live, work, and attend church and social gatherings with farmers in the same rural communities. It is important that nurses be aware of local issues that may impact farmers. If the weather has been particularly bad, if damaging winds have caused barns to collapse, if the fields are not being planted at their usual times, or if businesses are closing their doors; all these are signs of potential stress for the local farm economy. An increase in office visits for vague complaints of fatigue, insomnia, or gastrointestinal distress may be markers of increased stress. These symptoms may affect the entire farm family, not just the primary farmer. Also, nurses should become familiar with local and regional resources. Many rural communities do not have specialized mental health clinics, but there may be other supportive organizations available for the farmer. Establishing a link with the school system’s health resources and the local health department may help identify those in need of assistance. Nurses should equip themselves by learning more about the health issues of farmers. Three excellent sources for free education include 1) AgriSafe – a non-profit organization that specializes in agricultural health and safety (located at www.agrisafe.com), 2) a more local Facebook site, AgNURSE (www.facebook.com/Agriculture.nurse), and 3) an online, interactive continuing education course, Mental Health Issues in Agricultural Populations, #1068945 (located at www. https://ky.train.org/).

ConclusionThe enormity of the burden of stress, depression, and

suicide on Kentucky farms affects all of us. Kentucky is predominantly an agricultural state and highly dependent on agricultural income. Family farms encompass multiple generations and the stress related to farming extends to all generations on the farm. The link between stress and injury in farming (Grisso et al., 2008) creates an even more commanding reason to examine how farmers can cope with stress without ruining their health. Nurses are trusted professionals in the community and may be the first line of defense for farmers who are experiencing stress and depression and, therefore, serve as the key to the prevention of the spread of the suicide epidemic.

ReferencesBlackwell, T. L., & McDermott, A. N. (2014). Test review: Patient health

questionnaire-9 (PHQ-9). Rehabilitation Counseling Bulletin, 57(4), 246-248. doi: 10.1177/0034355213515305

Booth, N., Briscoe, M., & Powell, R. (2000). Suicide in the farming community: Methods used and contact with health services. Occupational and Environmental Medicine, 5(9), 622-644. doi: 10.1186/s12889-016-3664-y

Boxer, P. A., Burnett, C., & Swanson, N. (1995, April). Suicide and occupation: A review of the literature. Journal of Occupational and Environmental Medicine, 37(4), 442-452. Retrieved from http://www.joem.org/pt/re/joem/abstract.00043764-199504000-00016.htm

Browning, S. R., Westneat, S. C., & McKnight, R. H. (2008). Suicides among farmers in three southeastern states, 1990-1998. Journal of Agricultural Safety and Health, 14(4), 461-472. doi: 10.13031/2013.25282

Donham, K. J., & Thelin, A. (2006). Psychosocial conditions in agriculture. In K. Donham & A. Thelin (Eds). Agriculture Medicine: Occupational and Environmental Health for the Health Professions. Ames, Iowa: Blackwell Publishing.

Fraser, C. E., Smith, K. B., Judd, F., Humphreys, J. S., Fragar, L. J., & Henderson, A. (2005). Farming and mental health problems and mental illness. International Journal of Social Psychiatry, 51(1), 340-349. doi: 10.1177/0020764005060844

Grisso, R. D., Mariger, S. C., Wong, S. S., Perumpral, J. V., Christensen, N. K., Miller, R. L., & Sorenson, A. W. (2008). Depression as a risk factor for agricultural injuries. ASABE Paper No. 084166. St. Joseph, Mich: ASABE. Retrieved from http://bsesrv214.bse.vt.edu/Grisso/

Papers/084166_Depression.pdf Hirsch, J. K., & Cukrowicz, K. C. (2014). Suicide in rural areas: An updated

review of the literature. Journal of Rural Mental Health, 38(2), 65-78. doi: 10.1037/rmh0000018

Maciuba, S. M., Westneat, S. C., & Reed, D. B. (2013). Active coping, personal satisfaction, and attachment to land in older African-American farmers. Issues in Mental Health Nursing, 34(5), 335-43. doi: 10.3109/01612840.2012.753560

McIntosh, W. L., Spies, E., Stone, D. M., Lokey, C. N., Trudeau, A.T., & Bartholow, B. (2016). Suicide rates by occupational group---17 States. Morbidity and Mortal Weekly Report, 65, 641-645. doi: http://dx.dol.org/10.15585/mmwr.mm6525a1

Milner, A., Spittal, M. J., Pirkis, J., & La Montagne, A. D. (2013). Suicide by occupation: Systematic review and meta-analysis. The British Journal of Psychiatry, 203, 409-416. doi: 10.1192/bjp.bp.113.1284

Reed, D.B., Rayens, M. K., Conley, C., Westneat, S., Adkins, S. M. (2012). Farm elders define health as the ability to work. Workplace Safety and Health, 60 (8), 345-351.

Rossman, M. R. (2008). Behavioral health care of the agricultural population: A brief history. Journal of Rural Mental Health, 32(1), 39-48. doi: 10.1037/h0095960

Stallones, L, (1990). Suicide mortality among Kentucky farmers, 1979-1985. Suicide Life-Threatening Behavior, 20(2), 156-163.

Scott, R., Kegler, S. R., Stone, D. M., & Holland, K. M. Trends in Suicide by Level of Urbanization — United States, 1999–2015. MMWR Morb Mortal Wkly Rep 2017, 66(10), 270–273. doi: 10.15585/mmwr.mm6610a2

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Page 10 • Kentucky Nurse October, November, December 2017

Personal Experience

Rita Varnell, RN Surgical Services

I have been a nurse for many years, but every now and then there is a memorable patient who has a great impact on you and your practice. I work at a Children’s Hospital Operating Room and summer is a busy time for us.

On a busy summer day, we were working skeleton crew, several of which were new staff members recently off orientation. The day was extremely busy with scheduled surgeries and several emergency add-ons. We were informed of a Trauma patient that would be coming to the OR, but the patient took a downward turn and it became imperative this patient come to surgery immediately.

The room was prepared. Anesthesiologists and surgeons got ready to bring this very sick child to the Operating Room. Blood, albumin and other medications had been ordered and were ready to administer. The patient arrived in surgery and the OR staff were keenly aware this was going to be a difficult case since the patient was so critically ill. Often, in the operation room, staff are not aware of what is going on in other rooms, but because of this patient’s condition, all of the staff were on high alert. We all knew. The surgery lasted all day. The family was given hourly updates on their child’s status and many of the Operating Room staff were involved in this case at some point in the day.

I had finished my room late in the day. I checked on the Trauma room that was going and they were doing a hand-off and changing staff members. I noticed that some of the staff corning into the case had just recently come off orientation. I knew they had nursing knowledge and were capable of finishing the case, but that they may not be completely comfortable and may need some assistance with a patient this acutely ill, so I stayed with them.

The case was coming to a close and dressings were being applied. It had been a very difficult procedure and the patient’s condition had been very labile-the child’s blood pressure had been vacillating and the anesthesia team worked hard to stabilize him throughout the procedure. There had been numerous units of blood products and albumin given. At the end of the case it is not uncommon for the surgeons to remain in the Operating Room until the patient is transported to the Recovery Room, especially with a patient this ill. Everyone was still present in the room so I felt it was safe for me to move on to my next assignment. The Operating Room had other Traumas and scheduled cases going on during this time.

I had just left the room and was walking down the hallway to check the schedule board for my next assignment, when the Code Alarm went off. Many of us went running to the room. I noted the code cart was in place, compressions were being done by an Anesthesia Tech. I was given the task of assisting Anesthesia and obtaining medications from the code cart. We worked for approximately 30 to 40 minutes and it was a very orderly well run code, but to no avail. Despite everyone’s exhaustive efforts and doing everything we could possibly do for our patient, the surgeon and Anesthesiologist made the decision to pronounce.

Now we had the horrific job of informing the family. I was asked to go with the two physicians to inform the family. In the waiting room were the parents, and family. The Chaplain was already present to support the family due to the severity and length of the procedure. We had the family wait in our Conference Room for more privacy. I had never been in the position of being present with the physician to deliver such devastating news to a family.

It was a heartbreaking moment for the surgical team as we are used to FIXING IT. Unfortunately, not this time. The physicians returned to finish up what they needed to do while I stayed with the family to comfort them as they made very difficult decisions no parent wants to ever make. Then, the father looked at me and said, “ I want and need to see my child.”

I tried to explain as gently as I could that his child was still in the OR and he stated, I don’t care; I want to see my child now.” I thought if this were my child, I would probably feel the same way. So I said, “OK, give me a couple of minutes.” I hurried back to the room and assisted and instructed the remaining staff in cleaning up and making things as presentable as possible for this grieving family.

I escorted the family to the OR where they spent time with their child. The staff let them have alone time while the Chaplain assisted in providing prayers and comfort for the family. After some time, the family felt they could leave. As they left and walked toward the exit, the father turned around and begged me, “ Please, just one more visit?’ I walked him back to be with his child for a bit longer.

When the family did decide they could actually leave, it was time for us to complete the necessary tasks in coordination with our Chaplain. Since we had so many inexperienced staff members, I felt I needed to lead the team to finish up what needed to be done. Another experienced nurse stayed and assisted us as well. We respectfully prepared and transported our patient to the morgue. We completed our charting and then the emotions of the moment emerged and I realized how physically and emotionally drained we all were.

There were now two Chaplains present and they asked the other staff nurse and myself to step away into the Conference Room. They wanted to know how we felt and how we were coping with the tragedy? We both responded. “We are fine, we have completed what needs to be done.” One of the Chaplains asked if she could bless our hands and I had never previously witnessed or experienced this.

After saying she could, I have to tell you I was moved to tears! The rest of the evening and many days after, I have thought of this patient, their family and that entire experience.

I now do the education for the Critical Events in the OR. I created a reference binder as a result of this experience, for new orientees on our unit. I always reflect back on this patient when teaching. I will never forget or minimize how we impact our families and how they impact us as nurses!

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October, November, December 2017 Kentucky Nurse • Page 11

KNA Education Summit

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October, November, December 2017 Kentucky Nurse • Page 12

Stepping Into a Culture of SafetyOnboarding programs help retain nurses, strengthen patient care

Reprinted with permission of The American Nurse

Retaining newly hired, competent nurses — whether new graduates or experienced RNs — is good for everyone: employers, staff, patients and the new employees, themselves. What is vital to their tenure, however, may be how they are transitioned into the workplace and whether the organization is committed to a culture of safety.

“Orientation is the first step in retaining nurses,” said Dennis Sherrod, EdD, RN, professor and Forsyth Medical Center Endowed Chair of Recruitment and Retention at Winston-Salem State University and a member and past-president of the

North Carolina Nurses Association. “Although it’s difficult when working with a large group of new employees, it’s important that the orientation be nurse-centered, meaning individualized as much as possible to their needs, that there is a mentorship piece in place and that newly hired nurses are introduced to the culture of the workplace early on.”

Nurse turnover is an ongoing issue — with some health care facilities faring better than others. According to the 2016 National Healthcare Retention & RN Staffing Report by Nursing Solutions, Inc., (NSI) the turnover rate for bedside RNs rose to 17.2 percent in 2015, an increase from 16.4 percent in 2014.

According to a 2014 article in Policy, Politics, & Nursing Practice, New York University College of Nursing Professor and researcher Christine T. Kovner, PhD, RN, FAAN, and colleagues reported that about 17.5 percent of new nurses leave their initial job within the first year.

Beyond the upheaval on units, nurse turnover is costly. The NSI Nursing Solutions, Inc., (NSI) report noted “the average cost of a turnover for a bedside nurse ranges from $37,700 to $58,400, resulting in the average hospital losing $6.6 million. (Some reports place turnover costs even higher.)

Offering smoother and safer transitionsAn overarching goal of Southeastern Health’s orientation

program is promoting a culture of safety in newly hired employees – both new grads and experienced nurses, according to Cynthia McArthur-Kearney, DHA, MSN, RN, NE-BC, manager of Education Services at the North Carolina hospital system and NCNA member. This is accomplished, in part, by using concepts outlined in TeamSTEPPS.

TeamSTEPPS is a system aimed at assisting health care professionals to provide higher quality, safer patient care by strengthening their skills around teamwork, communication,

conflict resolution and eliminating barriers to ensuring the best clinical outcomes for patients.

All RNs going through the nursing services orientation are exposed to the program’s concepts, and all preceptors receive specialized TeamSTEPPS training so they can reinforce important concepts specifically to new grads during orientation and in their residency program.

“We don’t need to train new grads on how to insert catheters or change dressings,” McArthur-Kearney said. “Although the tasks are important, we want to teach them critical thinking. And the focus needs to be on safety. We need to make sure new grads – and all our nurses – understand what a culture of safety looks like and why it’s important.”

For example, preceptors working with new grads emphasize the importance of teamwork to achieving positive patient outcomes, understanding the roles of each team

ANA News

Stepping Into a Culture of Safety continued on page 13

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October, November, December 2017 Kentucky Nurse • Page 13

Membership Activation FormFor dues rates and other information, contact ANA’s Membership Billing Department at (800) 923-7709 or e-mail us at [email protected]

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Please Note — $20 of your membership dues is for a subscription to The American Nurse and $27 is for a subscription to American Nurse Today.American Nurses Association (ANA) member ship dues are not deductible as charitable contributions for tax purposes, but may be deductible as abusiness expense. However, the percentage of dues used for lobbying bythe ANA is not deductible as a business expense and changes each year.Please check with ANA for the correct amount.

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member, and how to communicate effectively with team members, including patients and their families. Role playing is often employed, such as learning how to have an effective conversation with a team member who may want to do a clinical task in an outdated way, explained McArthur-Kearney.

“To have a culture of safety, nurses also need to be aware of their environment, what’s going on around them,” McArthur-Kearney said. “So we emphasize that if a nurse sees a team member who is not filling a role during a code or who appears overloaded with an influx of patients, for example, that nurse must step up to ensure the best patient outcomes.” They also are taught how to identify when a situation may be getting out of control, as well as de-escalation strategies.

Another important component of on-boarding at Southeastern Health is orienting all newly hired staff on concepts outlined in the hospital’s strategic pillars. These concepts focus on embracing a language of caring, being fully present when interacting with colleagues, patients and family members, and showing kindness, including through non-verbal cues.

Added McArthur-Kearney, these strategies not only help to create and maintain a culture of safety, but also help with staff retention.

Another approach to quality and safetyThe University of Alabama at Birmingham Medical Center

changed the way it conducted its orientation and residency programs for new hires about four years ago, according to David James, DNP, RN, CCRN, CCNS, who previously served as the advanced practice nurse coordinator for Clinical Nursing Excellence at UABMC and is an Alabama State Nurses Association member.

“Orientation used to be more of an inservice-type model with a lot of content and a ‘parade of stars,’ where staff from various departments were given a few minutes to discuss their roles,” James said. “Now we’ve moved to a different model, taking the Quality & Safety Education for Nurses competencies used at the UAB School of Nursing and using them for our orientation schema.”

Developed by nurse leaders involved in the QSEN initiative, the competencies address quality and safety education around patient-centered care; teamwork and collaboration; evidence-based practice; quality improvement; safety; and informatics. (Please see the QSEN Institute website at www.qsen.org.)

Each day of the UABMC orientation is linked to one of those core competencies, James said. And although having everyone understand that patient safety is essential, it’s extremely important that nurses know what systems are in place to support patient safety – whether it’s evidence-based practice or the use of technology.

In terms of structure, all newly licensed RNs attend the five-day orientation, which also addresses UABMC workplace culture, and then participate in a yearlong residency program to help ease their transition into practice and hardwire key competencies, according to Connie White-Williams, PhD, RN, NE-BC, FAAN, the director of UABMC’s Center for Nursing Excellence and an American Nurses Association member.

“Our onboarding process for experienced nurses beyond the orientation is unit-based and individualized to their needs,” she said. For example, a nurse who has 15 years in cardiac

Stepping Into a Culture of Safety continued on page 15

Stepping Into a Culture of Safety continued from page 12

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Page 14 • Kentucky Nurse October, November, December 2017

KNA Centennial VideoLest We Forget

Kentucky’s POW NursesThis 45-minute video documentary is a KNA Centennial Program Planning Committee project and was premiered and applauded at the KNA 2005 Convention. “During the celebration of 100 years of nursing in Kentucky—Not To Remember The Four Army Nurses From Kentucky Who Were Japanese prisoners for 33 months in World War II, would be a tragedy. Their story is inspirational and it is hoped that it will be shown widespread in all districts and in schools throughout Kentucky.

POW NURSESEarleen Allen Frances, Bardwell

Mary Jo Oberst, OwensboroSallie Phillips Durrett, Louisville

Edith Shacklette, Cedarflat

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ANA News

The Centers for Medicare & Medicaid Services (CMS) is readying a fraud prevention initiative that removes Social Security numbers from Medicare cards to help combat identity theft, and safeguard taxpayer dollars. The new cards will use a unique, randomly-assigned number called a Medicare Beneficiary Identifier (MBI), to replace the Social Security-based Health Insurance Claim Number (HICN) currently used on the Medicare card. CMS will begin mailing new cards in April 2018 and will meet the congressional deadline for replacing all Medicare cards by April 2019. Today, CMS kicks-off a multi-faceted outreach campaign to help providers get ready for the new MBI.

“We’re taking this step to protect our seniors from fraudulent use of Social Security numbers which can lead to identity theft and illegal use of Medicare benefits,” said CMS Administrator Seema Verma. “We want to be sure that Medicare beneficiaries and healthcare providers know about these changes well in advance and have the information they need to make a seamless transition.”

Providers and beneficiaries will both be able to use secure look up tools that will support quick access to MBIs when they need them. There will also be a 21-month transition period where providers will be able to use either the MBI or the HICN further easing the transition.

CMS testified on Tuesday, May 23rd before the U.S. House Committee on Ways & Means Subcommittee on Social Security and U.S. House Committee on Oversight & Government Reform Subcommittee on Information Technology, addressing CMS’s comprehensive plan for the removal of Social Security numbers and transition to MBIs.

New Medicare Cards Offer Greater Protection to More Than 57.7 Million Americans

New cards will no longer contain Social Security numbers, to combat fraud and illegal use

Personal identity theft affects a large and growing number of seniors. People age 65 or older are increasingly the victims of this type of crime. Incidents among seniors increased to 2.6 million from 2.1 million between 2012 and 2014, according to the most current statistics from the Department of Justice. Identity theft can take not only an emotional toll on those who experience it, but also a financial one: Two-thirds of all identity theft victims reported a direct financial loss. It can also disrupt lives, damage credit ratings and result in inaccuracies in medical records and costly false claims.

Work on this important initiative began many years ago, and was accelerated following passage of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). CMS will assign all Medicare beneficiaries a new, unique MBI number which will contain a combination of numbers and uppercase letters. Beneficiaries will be instructed to safely and securely destroy their current Medicare cards and keep the new MBI confidential. Issuance of the new MBI will not change the benefits a Medicare beneficiary receives.

CMS is committed to a successful transition to the MBI for people with Medicare and for the health care provider community. CMS has a website dedicated to the Social Security Removal Initiative (SSNRI) where providers can find the latest information and sign-up for newsletters. CMS is also planning regular calls as a way to share updates and answer provider questions before and after new cards are mailed beginning in April 2018.

For more information, please visit: https://www.cms.gov/medicare/ssnri/index.html

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Knowledge for Life

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October, November, December 2017 Kentucky Nurse • Page 15

The Human Touch

Copyright1980| LimitedEditionPrintsbyMarjorieGlaserBindnerRNArtist

LimitedEditionFullColorPrint|Overallsize14x18|Signedandnumbered(750)—SOLDOUTSignedOnly(1,250)—$20.00|NoteCards—5perpackagefor$6.50

ThE PAiNTiNg“The Human Touch” is an original oil painting 12” x 16” on canvas which was the titled painting of Marge’s first art exhibit honoring colleagues in nursing. Prompted by many requests from nurses and others, she published a limited edition of full color prints. These may be obtained from the Kentucky Nurses Association.

*I wrote this poem to describe the painting, The Human Touch

by Marge.” Edmonds, Washington 1994

FOR MAIL OR FAx ORDERSI would like to order an art print of “The Human Touch”©

____Signed Prints @ $20.00 ____Total Purchases ____Package of Note Cards @ 5 for $6.50 ____Shipping & Handling (See Chart) ____Framed Signed Print @ $180.00 ____Subtotal ________Gold Frame Kentucky Residents Add 6% Kentucky Sales Tax ________Cherry Wood Frame Tax Exempt Organizations Must List Exempt Number ______TOTAL ____________

Makecheckpayabletoandsendorderto:KentuckyNursesAssociation,305TowneparkCircle,Suite100,Louisville,KY40243orfaxorderwithcreditcardpaymentinformationto(502)[email protected].

Name: ______________________________Phone: ____________________

Address: ______________________________________________________

City: _____________________ State _____________ ZipCode: __________

Visa/MasterCard/Discover: _________________________________________

ExpirationDate: ____________________ CIV: _______________________

Signature(Required): ______________________________________________

Shipping and Handling$0.01to$30.00 . . . . . . . $6.50$30.01to$60.00 . . . . $10.95$60.01to$200.00 . . .$30.00$200.01andup . . . . . . .$45.00

*Express delivery will be charged at cost and will be charged to a credit card after the shipment

is sent.

Stepping Into a Culture of Safety continued from page 13

care and is hired onto a neuro unit should not be expected to take a full workload as quickly as someone who was hired onto a unit they have vast experience in.

Further, White-Williams added that about a month after their employment, she and Chief Nursing Officer Terri Poe, DNP, RN, NE-BC, meet with these experienced nurse hires to get their input about what went well, where improvements can be made and whether they feel welcomed. And experienced nurses, like new grads, are assigned preceptors who serve as an ongoing resource.

But to ensure a culture of safety and to retain staff takes more.“We have probably 900 new nurses this year who we are trying to successfully orient and

onboard,” White-Williams said. “We’re no different than anyone else in terms of trying to retain folks. It really does take a village to do this successfully, and it takes a lot of resources.”

A journey toward safety“We say let’s hire for attitude and train for skill,” said Clyde A. Bristow III, MSN, RN, CENP, chief

nursing officer at Wake Forest Baptist Health Lexington Medical Center and director of Clinical Education. “We can teach nurses how to insert an IV, but what we’re looking for are things like how does the nurse engage and communicate with patients, do they make them feel safe.”

Safety is an ongoing theme at WFBH. All newly hired staff must attend a four-hour program called Safety Starts Here within their first 90 days of employment, according to Bristow.

“We start early by weaving in culture of safety principles – those based on high reliability and best practices – throughout our [orientation and new grad residency] programs, and all newly hired nurses must integrate them into their care,” Bristow said. Those principles range from engaging in daily safety huddles to maintaining patient privacy to working collaboratively with all disciplines, and they are constantly reinforced.

All new hires also must commit to WFBH’s “patient and family promise,” according to Phyllis Knight-Brown, MSN, RN, WFBH clinical education manager and a member of the Association of Nursing Professional Development, an organizational affiliate of the American Nurses Association. That promise speaks to staff pledging to patients that they will keep them safe, care for them, involve them and their families in care, and respect them and their time.

“We also try to empower all our nurses to feel they can say, ‘I have a concern’ or ‘I need help,’ especially new nurses so they are not struggling alone,” she said.

Looking specifically at newly hired, newly licensed RNs, WFBH provides them with a yearlong, residency-type program called Journeys. It consists of a general and a unit-based orientation; a structured preceptorship; quarterly workshops, which include simulated practice and didactic sessions; and the opportunity to network and gain support from their co-hort. Workshop content is specific to new nurses’ units, however, the eight-hour sessions also cover issues such as stress management and self care, cultural competence and diversity, safety terminology and resources, patient instability, and shared governance.

“We have some flexibility in the program so we can tailor it more to the needs of our new nurses,” Bristow said. “We don’t want to find out on the 89th day that they don’t get along with their preceptor or haven’t learned how to do x, y or z. So preceptors and nurse managers meet often to determine where someone might need training. Then that nurse is placed in a situation where he or she can learn, which really benefits them as new nurses.”

WFBH also has a network of resource nurses, including preceptors, who can continue to provide guidance and information after the orientation and residency is complete.

Final commentsThere is no secret recipe to creating a good orientation and onboarding program to

retain competent and safety-focused nurses, according to Sherrod. However, it needs to be competency-based, nurse managers and staff need to celebrate and welcome new hires, and everyone should have a mentor.

Beyond orientation and residencies, retention also is dependent on factors such as workload, effective collaboration, strong professional practice roles and a healthy work environment.

“Having this retention culture is a way to help prevent a revolving door of new hires and strengthen an organization’s culture of safety and retention by providing nurse-centered orientations and work policies,” Sherrod said. “And retention is everyone’s responsibility.”

– Susan Trossman is a writer-editor for the American Nurses Association.

The Human TouchHer step is heavyHer spirit is highHer gait is slowHer breath is quickHer stature is smallHer heart is big.She is an old womanAt the end of her lifeShe needs support and strengthFrom another.

The other woman offers her handShe supports her armShe walks at her paceShe listens intentlyShe looks at her face.She is a young woman at theBeginning of her life,But she is already an expert in caring.

RN PoetBeckie Stewart*

Job Summary: in collaboration with a physician, diagnoses and treats certain acute or chronic health conditions in the adult intensive care unit. training is provided relevant to the population served, based on scope of care of the service assignment.

Education: Master’s degree from an acute Care nurse practitioner program required.

Critical care experience preferred.

Now Hiring ICU APRN’s or PA’s!Owensboro Health · PULMONOLOGY

Owensboro, KY | Full-time, Days, 7am-7pm or 7pm-7am

For more information, contact Michelle Hayden, Physician Recruitment | Owensboro Health

270-993-0605 | [email protected]

Apply at www.owensborohealth.org/careers

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https://www.quitnowkentucky.org/en-US/Just-Looking/Health-Professional