the nursing voice · 2018-03-31 · reflect the many important roles nurses play in today’s...
TRANSCRIPT
Reinventing The Nursing VoiceBrenda Brozek, BSN, MAOL, RN
Editor, The Nursing Voice
As nurses, we continually explore strategies to improve our practice. The same holds true with The Nursing Voice. As we begin 2017, ANA\C is pleased to announce that we are working diligently to raise The Nursing Voice to a new level in providing valuable information and resources for the nurses of California. As you can see in this issue, we have a new masthead – the banner at the top of our front page, which also incorporates ANA\C’s new logo.
We designed this new masthead to more accurately reflect the many important roles nurses play in today’s health care arena, as well as the growing diversity of our profession. Our new logo and colors align us with the rebranding of the American Nurses Association.
This issue contains highlights from our 20th Anniversary Celebration and General Assembly, Making Waves: Empowering California Nurses, October 14-15, 2016 in Redondo Beach. On the following pages, you’ll find articles and photos from our outstanding educational presentations, business meeting, poster session, award ceremonies and other conference events.
Future issues will feature articles from a variety of practice areas. We invite you to submit articles of interest to RNs for publication in The Nursing Voice. You can submit finished articles or present an idea to us and we will provide guidance about transforming your concept into a viable article. We also would like your feedback and suggestions about improving our publication. And, we are looking for ANA\C members to serve on our Editorial Board.
If you’re interested in serving on the ANA\C Editorial Board or would like to submit articles, ideas and suggestions for The Nursing Voice, please email us at: [email protected].
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INSIDE THIS ISSUE
ANA\C 20th Anniversary Celebration & General Assembly . . . . . . . . . . . . . . . . . . . . . 3-10
Mentoring Our Next Generation of Nurses . . . .11
Participating in Lifelong Learning Activities . . . 11
2016 Highlights: Legislation, Regulation and Endorsement . . . . . . . . . . . . . . . . . . . . . . . 12
American Nurses Advocacy Institute: Developing Nurses into Political Leaders . . . 12
Promoting the Code of Ethics for Nurses: Assessment of Decision Making Capacity . . . . . . . . . . . . . . . . . . . .13
CE = EZ4 U . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
ANA\C Executive Director Receives Arizona’s Legend in Nursing Award . . . . . .15
Membership Application . . . . . . . . . . . . . . . . .15
THE NURSING VOICEANA\C is an affiliate of the American Nurses AssociationVOlUmE 22 | ISSUE 1 | JanUary, FEbrUary, marCH 2017
Corinne MacEgan, MSN/Ed, RN, CHPN ANA\C President 2015-2017
I’m sitting on my balcony watching two hummingbirds whiz back and forth, always so busy and on the go. It’s a gorgeous day, one of those San Diego afternoons when you’re reminded that you’re human and the world is surrounding you with its energy. It’s a time to feel small, and a time to feel giant – where anything is possible!
Poeticism aside, I was thinking about the success of our 2016 20th Anniversary Celebration and General Assembly in Redondo Beach. If you weren’t one of our 70+ attendees, I encourage you to read this issue with a good, strong cup of coffee so you can experience the energy buzz that rocked the conference center throughout our 2-day event (of course, only if cardiovascularly appropriate!). From the opening keynote address by ANA President Dr. Pam Cipriano, to a special award ceremony for Congresswoman Lois Capps and presentations from some of the most inspirational nurses, leaders and experts you could ever hope to meet – the GA was a stellar event. Vice President Anne Hughes and her team collaborated to make our 20th anniversary conference a happening to be remembered. I can’t thank them enough for their hard work. The enthusiasm of our attendees also made this assembly something special. Their vocal involvement, committed conversation, and networking
was incredible to witness. I’m extremely proud to be in this profession with all of you.
I’m happy to report that much was accomplished in our business meeting. We successfully updated and passed several revisions to our bylaws. Kathy Falco and her team worked endlessly to ensure appropriate verbiage and coalescence with ANA national bylaws. We approved our new mission statement: “To enhance the health and well-being of Californians and advance the profession of nursing.”
In addition, we approved the retirement of several resolutions that were determined to be outdated or resolved through the work of nursing nationwide (this list can be found in this edition of Nursing Voice and the ANA\C website). These decisions pave the way for current and new resolutions to be brought forward for us to consider. The Board of Directors also brought forth a motion to integrate a new statement, Nurses EASE Their Young, into our practice. You can read more about this in my article about the panel on transitions.
As we begin the new year with more than 5,000 members, I encourage you to become more involved in our professional organization. We have taskforces, committees and will be increasingly active in work within and outside of California, due to our participation in the Western Multistate Division and the new pilot pricing program. If you’re interested in volunteering, complete the Committee Interest Form on our website, or contact us by email at [email protected].
Stop by our office in Sacramento, and meet Marketa and Teresa, if you haven’t already. Share your stories with us – what you love about nursing, what needs work and what you’re doing about it. We have a wall of fame in our new office that needs pictures of you doing the work you love. As always, if there’s anything I can do for you, I’m available at [email protected]. I look forward to hearing from you!
Corinne MacEgan,MSN/Ed, RN, CHPN
Brenda Brozek, BSN, MAOL, RN
President’s Perspective Editor’s Message
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Page 2 • ANA\C The Nursing Voice January, February, March 2017
American Nurses Association\California is an Affiliate of the American Nurses Association
The Nursing Voice is the official publication of theAmerican Nurses’ Association\California
ANA\C is located inThe Senator Office Building
1121 L. Street, Suite 406Sacramento, CA 95814
Office 916-447-0225 – Fax 916-442-4394Association E-mail [email protected]
The Nursing Voice Editor E-mail [email protected]
ANA\C 2015 BOARD OF DIRECTORS
Officers Corinne MacEgan, MSN/Ed, RN, CHPN - President Anne Hughes, APRN, PhD, FAAN - Vice PresidentMelanie Krupa-Kelly, RN, MSN, CNOR - Treasurer
Matthew Grayson, BSN, RN - Secretary
Directors Mary Ellen Dellefield, PhD, RN - Nursing Practice Director
Mary Ann McCarthy, EdD, MSN/CNS/NE, STAH, PHN- Nursing Education Director
Phillip Bautista, BSN, RN, PHN - Membership DirectorElizabeth O. Dietz, EdD, RN, CS-NP -
Legislative Director
ADMINISTRATIONExecutive Director: Robin Schaeffer, MSN, RN, CAEGovernment Affairs Director, Senior Policy Analyst, Office Manager: Markéta Houšková, RN, MAIA, BA
Lobbyist: Roxanne GouldWebsite/Nursing Voice: Brenda Brozek, MAOL, RN
The official publication of the ANA\C shall be The Nursing Voice.
The Nursing Voice is published quarterly starting in January; copy must be received by the first (1st) of November, February, May, and August to be included in the next publication. The publication is complimentary to ANA\C members, schools of nursing and their nursing students, affiliates of the association and their memberships. If you would like to submit a letter, article, or manuscript, for publication please read ‘Article Submission for The Nursing Voice’ in this issue for submission details.
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ANA\California accepts and encourages manuscripts and editorials be submitted for publication in the association’s quarterly newsletter, The Nursing Voice. We will determine which letters and articles are printed by the availability of publication space and appropriateness of the material. When there is space available, ANA\C members will be given first consideration for publication. We welcome signed letters of 300 words or less, typed and double spaced and articles of 1,500 words or less, typed and double spaced. ANA\C will accept larger narrative if space permits. For more information please email [email protected] or call 916.447.0225.
ANA\California’s official publication, ‘The Nursing Voice’ editorial guidelines and due dates for article submittal is as follows.
1. Letters, Articles and Manuscripts should be word processed and double-spaced on one side of 8 ½ x 11 inch white paper. Manuscripts should be emailed to Editor at [email protected] a. Letters, Articles and Manuscripts should
include a cover page with the author’s name, credentials, present position, address and telephone number. In case of multiple authors, list the names in order in which they should appear.
b. The Nursing Voice reserves one-time publication rights. Letters, Articles and Manuscripts for reprint will be accepted if accompanied with written permission.
c. The Nursing Voice reserves the right to edit Letters, Articles and Manuscripts to meet style and space limitations.
d. Letters, Articles and Manuscripts may be reviewed by the Editorial Staff.
e. Letters, Articles and Manuscripts submitted by members’ of ANA\C will be given first consideration when there is an availability of space in the newsletter.
f. Letters, Articles and Manuscripts submitted to ANA\C will be published as space allows unless content is of a timely nature.
g. Letters, Articles and Manuscripts printed in The Nursing Voice do not necessarily reflect the views of ANA\C, its membership, the board of directors or its staff.
2. Photographs should be in jpeg format and emailed with the name of the Letter, Articles or Manuscript referenced in the subject line. Email to [email protected] Photographs should be of clear quality. Write the name(s) of the persons displayed in the photo in the order in which they appear in the body of the email.
3. E-mail all narrative to [email protected]
arTIClE SUbmITTal TO ‘ThE NURSING VoIcE’
hElP US STay IN ToUch: Do you have a new address or e-mail address?
You can help American Nurses Association\California ‘stay in touch’ by updating your contact information. Call ANA\C at 916-447-0225, e-mail us at [email protected] or return this form to:
The ‘Nursing Voice’c/o ANA\C1121 L Street, Suite 406Sacramento, CA 95814
ANA\C Member Identification No. (if applicable) _______________________________________________
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January, February, March 2017 ANA\C The Nursing Voice • Page 3
ANA\C 20th Anniversary Celebration & General Assembly
Marketa Houskova, RN, MAIA, BA ANA\C Government Affairs Director
“Nurses must be allowed to practice in accordance with their professional training …and assume leadership roles in the
redesign of the health care system” -Harvey Fineberg, MD, Former President, Institute of Medicine
Growing up in Czechoslovakia, one of my Mom’s somewhat effective parenting tools was her not-so-veiled threat of “you will become like them if you stay surrounded by them!” While her worry that I may not achieve full potential, or lose my will to succeed based on the company I kept proved totally unfounded, her overall hypothesis of influenced by association may have some merit in certain circumstances. Intentionally surrounding yourself with people you want to be “like” can be a strategy to help you learn and grow. Case in point, ANA\C’s 2016 General Assembly 2016 in Redondo Beach where I was afforded an unforgettable opportunity to be influenced by association.
It was amazing to be surrounded by many outstanding nurses and leaders such as our keynote speaker, ANA President Pam Cipriano, PhD, RN, NEA-BC, FAAN, who was named in the Top 25 Women in Healthcare and Top 100 Most Influential People in Healthcare in 2015 and 2016.
Cipriano delivered a rousing presentation on nursing leadership, From Bedside to Boardroom, to open the General
ANA President Pam Cipriano Opens ANA\C General AssemblyAssembly. Did you know that with 3.6 million registered nurses in the United States, and about 420,000 in California, we only hold about 5 percent of hospital board positions? Yes, we are the largest employee group in any hospital, yet our professional voice is not represented on most of the hospital boards in our country! To make matters even more frustrating, nearly half of US hospital boards do not have racial or ethnic minority representation whatsoever. If this is not a call to action, I do not know what is.
“Nurses are the experts in the patient and family experience, quality and patient safety and improving the system to reduce costs,” said Cipriano. “It’s time they play a greater role in the boardroom.”
Through her inspiring presentation, Cipriano challenged us to more actively lead change in health care by seeking positions on boards. She described the National Nurses on Boards Initiative that calls for 10,000 nurses to serve on boards by 2020. These boards include hospital, corporate, nonprofit, community advisory and others. (Learn more at: http://campaignforaction.org/join-effort-get-10000-nurses-onto-boards-2020/
It’s about time for nurses to have a voice on boards – we bring a different skill set to boardrooms, and we employ critical thinking and analytical abilities honed by years of nursing practice. And what of nurses being voted the most trusted and ethical profession for the 13th year in a row? Icing on the cake!
ANA President Pam Cipriano challenges ANA\C members to lead change by serving on boards.
Page 4 • ANA\C The Nursing Voice January, February, March 2017
ANA\C 20th Anniversary Celebration & General Assembly
Jimil-Anne Linton, BSN, RN, PHN
During the 2016 ANA\C General Assembly, I had the pleasure of participating on the transitions in practice discussion panel. I must admit that I was somewhat nervous during my preparation for this discussion. When conversation began during the planning phase earlier this year, I was originally invited to participate because I had recently transitioned to a job in a new specialty. By the time the General Assembly came around, I had already left that job and was a little embarrassed to say that the specialty was not for me. But after sharing my story on the panel, there was an outpouring from fellow nurses who shared similar sentiments with various aspects of my experience.
So, here’s my story…I am a new graduate registered nurse with nearly 1.5
years of RN experience. In my short tenure as a nurse, I have already experienced several transitions: from student to new grad, floor nurse to charge nurse, then becoming a certified instructor to train other mental health workers on non-violent crisis intervention. The challenges of these roles were already daunting – on top of the existing obstacles of being a new grad.
After receiving my RN license, I jumped right into the world of psychiatric nursing – working in acute psychiatric care for the County of Santa Barbara. From the moment I considered nursing as a career, I knew I wanted to work in mental health. However, while I was in nursing school, I found myself enjoying other areas of nursing such as medical-surgical, cardiac care, and pediatrics. I suddenly
pictured myself practicing in these areas. Additionally, the demands of the medical-surgical curriculum led me to believe that I would not be successful in my career if I did not start my practice working in a hospital or acute clinical setting. As I neared graduation from nursing school, I was going through a difficult divorce in addition to beginning my job search. During that time, the new graduate programs for acute care had just closed in my area. Suffice to say, the first opportunity that presented itself to me was in mental health, and I embraced it.
Shortly after completing my first year as a nurse, my curiosity about acute care nursing emerged. As such, I applied for a position in a transition to acute care program at a major hospital in my area. To my surprise, the moment the notion entered my mind to the time I started the program was only two weeks! I suddenly went from practicing as a psychiatric nurse to training and practicing as a surgical-trauma nurse. The transition program was six weeks long, and I understood that the learning curve for this area of nursing would be rather steep. I am happy to say that I survived the didactic lectures, simulation exercises, and clinical preceptorship and spent several weeks on the floor on my own. Yet, I found myself rather disappointed in my decision to make this move.
The fast-paced operational tempo of the surgical-trauma unit did not afford me the time to develop the level of rapport I was used to establishing with my psychiatric
Finding Your Niche: Transitioning to Another Specialty and Backpatients. One of my toughest experiences was holding my cancer patient’s hand and having to leave the room only a minute later because my pager went off incessantly: Patient in Room 1 needs pain medication; Dr. Smith is on line 2 returning your call about patient in Room 2; PACU is on line 3 ready to give you report on your post-op admit; Room 4’s urine output was only 90 milliliters over the past eight hours; and the list goes on.
My patient cried as I let go of her hand and left with a rushed apology. Most days I would go to lunch for only 30 minutes while constantly worrying about the patients under my care. When the 12.5-hour workday was through, I would drive home for another hour – just to do it all again the next day. Additionally, I had two children who needed my attention the moment I set foot into my home. I was stressed, and I began to feel myself burning out! It wasn’t until an emergent family and health situation arose that I made the decision to resign from my position as a surgical-trauma nurse. For a couple of weeks after I left that job, I had frequent feelings of disappointment. But I was offered my previous psychiatric nurse position, and I suddenly found myself loving nursing again!
Psychiatric nursing, so I’m told, is not an area that many nurses want to work in. I’ve heard some nurses refer to psychiatric nursing as “the nursing graveyard” or the area that nurses go to retire. I beg to differ! It takes a special type of person to work with the mental health population. I too suffer from mental illness: post-traumatic stress disorder coupled with severe anxiety and depression. Sometimes I can relate to the struggles my patients go through, and that has helped in their healing. I enjoy what I do and I find this specialty to be my calling.
So, the burning question is: did I regret exploring another specialty? No! I learned and refreshed my clinical skills, my clinical judgement and sense of autonomy are stronger, and I learned how to adapt to another clinical environment and its own set of challenges. I imagine myself constantly questioning whether I had missed an opportunity if I didn’t explore surgical-trauma nursing.
My point in sharing my story is not to assert that one specialty is better than another, but to show other nurses that each of us are drawn to a particular practice area for a reason. Many of us find ourselves attracted to a specialty and end up practicing there for an entire career – not out of complacency, but out of passion. The most valuable lesson I learned from this experience is that nursing is an amazing profession with a plethora of career paths to choose from.
If there is any wisdom I can impart from this experience, it would be that each of us is a unique human being. As nurses and individuals, we each have our own niche in the nursing profession. Choose your path based on what’s right for you.
Jimil-Anne Linton at the ANA\C General Assembly.
– late October and provided feedback in preparation for ANA’s the national launch in January 2017.
The Healthy Nurse, Healthy NationTM concept tied in nicely to the presentation Marsha Fowler, PhD, MDiv, MS, RN, FAAN, presented earlier in the conference on our Nursing Code of Ethics. As defined in provision number five of the 2015 Nursing Code of Ethics: “Nurses should model the same health maintenance and health promotion measures that they teach and research, obtain health care when needed, and avoid taking unnecessary risks to health or safety in the course of their professional and personal activities.”
It should be a priority for nurses to promote self-care for our patients and achieve self-care for ourselves. Similar to the airline concept of “putting on your own oxygen mask before helping others,” nurses need to take care of themselves prior to helping others whether at work or at home. We need to be our own priority number one!
Recognizing that nurses are the ultimate care givers (usually to others first), ANA requests that nurses accepting the Healthy Nurse, Healthy NationTM challenge first complete a comprehensive survey to determine their primary areas of need. Once the survey is complete, the nurse is directed to proven interventions that can help individuals develop a personal plan to improve health and wellness. Initial steps to self-care and more information about the Healthy Nurse, Healthy NationTM Grand Challenge can be discovered on the ANA website.
During one of the breakout sessions, attendees also discussed best practices in their work environment to engage nurses and decrease stress. Suggestions included
unit based Zen rooms for relaxation, live music programs, float nurses to off-load the stress on the unit, and staff combining their talents with other units for fun events, such as sing-alongs.
Imagine if all 3.6 million nurses improved their health and encouraged those around them from their families and communities to improve just a little – how much healthier our world could be!
ANA’s Healthy Nurse Healthy NationTM InitiativeImprove the health of the nation by improving the health of the nurse
Anita Girard, DNP, RN, CNL, CPHQ, NEA-BC
How do we improve the health of our nation? To answer this question, asked daily by health care providers, the American Nurses Association (ANA) is challenging all nurses to model the way by engaging in positive habits to improve the health of 3.6 million RNs across the country through participation in the Healthy Nurse, Healthy NationTM challenge.
ANA defines a healthy nurse as:
One who actively focuses on creating and maintaining a balance and synergy of physical, intellectual, emotional, social, spiritual, personal and professional wellbeing. A healthy nurse lives life to the fullest capacity, across the wellness/illness continuum, as they become stronger role models, advocates, and educators, personally, for their families, their communities and work environments, and ultimately for their patients.
In October at ANA\C’s General Assembly, Jaime Murphy Dawson, ANA’s Healthy Nurse, Healthy NationTM program manager, presented an overview of the program to RNs in attendance. What a great idea to demonstrate that California nurses can be health care coaches and role models for a healthy lifestyle. As innovators and early adopters, ANA\C has taken on the challenge and volunteered to be one of the beta testers of this new program. ANA\C members tested the system in September Jaime Murphy Dawson from ANA describes the
Healthy Nurse Healthy NationTM Grand Challenge.
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January, February, March 2017 ANA\C The Nursing Voice • Page 5
Want to make a difference in the quality of health care?The Center for Health Care Quality is recruiting Registered Nurses to fill . . .
offering comprehensive Benefits:
• Industry leading Benefits Package• Part-Time Positions considered• Medical/Dental/Vision• Flex Elect Medical & Dependent care account• annual Salary Ranges From $64,080 – $83,412• Flexible Schedule• Paid holidays and Sick/Vacation Time• Extensive State and Federal Training• Two Professional Development Days• 457/401 (k) Savings Plus Program• Generous Retirement Plan• Promotional career opportunities
District office locations:
• Bakersfield• Chico• San Francisco• East Bay (Richmond)• Fresno• Orange• Riverside• Sacramento• San Bernardino• San Diego• San Jose• Santa Rosa• Ventura
State Employment Requires Passing an Eligibility Examination.Apply now! HFEN employment opportunities are available statewide
and the online eligibility exam can be accessed anytime at: www.cdph.ca.gov/nursingjobs
QUESTIoNS? Please e-mail our friendly personnel liaison at: [email protected], call (916) 322-9905.
The California Department of Public Health is an Equal Opportunity Employer.
health Facilities Evaluator Nurse (hFEN) PositionsThe Health Facilities Evaluator Nurse conducts inspections,
investigations, surveys, and evaluations of health care facilities.
Page 6 • ANA\C The Nursing Voice January, February, March 2017
ANA\C 20th Anniversary Celebration & General Assembly
January, February, March 2017 ANA\C The Nursing Voice • Page 7
ANA\C 20th Anniversary Celebration & General Assembly
• Delia Santana’s study used the qualitative approach of phenomenology to explore factors that contribute to low rates of influenza vaccination in older African Americans (population health/patient safety/patient experience).
• Annie Tat’s project focused on raising the awareness of nursing students in appreciating the lives of low income, ethnically diverse women with chronic illness by using the framework of cultural humility (population health/patient experience).
Clearly these nurse colleagues are contributing enormously to the evidence base of nursing practice and assisting nurses in improving care delivered to patients and communities. Please consider how your efforts to improve nursing and identify best practices can be shared with your colleagues.
Poster Presentations: Identifying and Sharing Best Evidence to Improve Nursing Practice
Anne Hughes, PhD, FNP, ACHPN,
ACRN, FAAN
Annie Tat discusses her work during the poster session at the General Assembly.
Anne Hughes, PhD, FNP, ACHPN, ACRN, FAAN ANA\C Vice President and Chair of 2016 General Assembly Planning Committee
Florence Nightingale, founder of modern nursing, insisted that a common-sense principle of (hospital) care was that patients would not be harmed by the care itself. As a practice discipline that is both art and science, nursing is called to ensure that the care delivered is safe, effective and person-centered. The basis of this claim is the requirement that nurses continually examine their practice for the best knowledge or evidence by studying the needs of patients, communities and the delivery of care in health care settings; by testing models to improve care and sharing the results of these efforts.
Seven nurses and their co-authors shared their work to improve care and advance nursing practice in poster presentations at the 2016 ANA\C General Assembly. Collectively their work brilliantly illustrated the breadth of nursing practice and the diversity and complexity of patient/population needs. In addition, their work addressed one or more of the Institute for Healthcare Improvement’s Triple Aims for improving health care (patient experience, population health and cost effectiveness) and ANA’s 2016 Culture of Patient Safety focus.
Highlights of poster presentations:• Cynthia Stacy and collaborators explored the experiences of nurses working on
acuity adaptable units (cost effectiveness and patient safety); their poster was selected by conference attendees for the People’s Choice Award.
• Pamela Cone and colleagues’ study examined the comfort of nurses in assessing the spiritual needs of their patients (patient experience).
• Veronica Timple’s preliminary dissertation research is directed at identifying contributing factors resulting in readmission of people living with Type II Diabetes (population health/cost effectiveness).
• Rachel Choudhury conducted psychometric testing of a telemetry monitoring tool used to evaluate nurse competency (patient safety).
• Brian Harradine described use of the organizational performance improvement strategy, LEAN, to improve compliance with pre-operative procedure checklist (patient safety/cost effectiveness).
JOIN OUR NURSING TEAM!EXCELLENT BENEFITS AND RETIREMENT
San Bernardino County Department of Public Health is recruiting for Registered Nurse I & II – Public Health and Public Health Nurse I & II positions.
For more details, please review the announcements atwww.sbcounty.gov/hr
Application can be made on-line – apply ASAP. (909) 387-8304 - EEO/ADA
Page 8 • ANA\C The Nursing Voice January, February, March 2017
ANA\C 20th Anniversary Celebration & General Assembly
ANA\C recognized several nurses for their outstanding contributions to the nursing profession and patient care during an Awards Ceremony at the 2016 General Assembly
Florence Nightingale AwardRecognizes the delivery of outstanding direct patient
care by a registered nurse.
Captain Rupert B. Laco, MSN, RN, CSMRN
Captain Laco is a clinical nurse in the inpatient unit at David Grant USAF Medical Center at Travis Air Force Base. He is recognized for his professionalism, clinical expertise and positive interpersonal and interprofessional working relationships. In his hospital, Captain Laco serves as point of contact for the Basic Life Support and Patient Root Cause Analysis programs. Additionally, he spearheaded a peer review program on his inpatient unit. His award nominator stated that Captain Laco consistently demonstrates the values of “integrity first, service before self and excellence in all we do.”
ANA\C Recognizes Excellence in Nursing Practice and Patient CareRay Cox Award
Recognizes the lifelong commitment of an RN in the advancement of the nursing profession in California.
Joyce Newman Giger, PhD, RN, FAAN
Dr. Giger, Professor Emeritus from UCLA School of Nursing, has educated and mentored thousands of nursing students and advanced nursing practice to improve the lives of patients around the globe. Dr. Giger developed, tested and implemented the Transcultural Nursing Model, which guided day-to-day patient-centered nursing care and served as theoretical framework for research. In her role as Editor of the Journal of the Black Nurses Association, Dr. Giger has coached many minority nurses. She was nominated by the White House to the National Institute of Nursing Research, an advisory council of the National Institute of Health, and has chaired ANA councils on culture, diversity, genetics, and long term care. Dr. Giger is an admired colleague and dedicated public servant.
Elizabeth “Betty” Curtis AwardRecognizes a registered nurse who is an advocate
on behalf of nursing and health care in the legislative, regulatory and/or other public policy arenas.
Elizabeth Dietz, EdD, RN, CS-NP
A Professor Emeritus at San Jose State University, Dr. Dietz serves on ANA\C’s Board as Legislative Director. In this role, she chairs the Legislative Committee, coaches nurses in effective health policy advocacy, and collaborates with ANA\C staff to represent the interests of the nursing profession. She also attends meetings of the Board of Registered Nursing, legislative hearings and political events on behalf of ANA\C. Dr. Dietz serves on ANA’s Political Action Committee and is a former member of the California BRN. Her service to ANA at the national and state levels is legendary. She is also a longtime Red Cross volunteer nurse and has been honored by this organization for her service.
JoAnne Powell AwardRecognizes an RN demonstrating outstanding
leadership, research, or contributions to the body of knowledge affecting nursing.
Cecelia L. Crawford, DNP, RNDr. Crawford is a Practice
Specialist for Evidence-Based Practice and Program Evaluation for the Regional Nursing Research Program at Kaiser Permanente Southern California. Dr. Crawford has been a champion for the nursing profession for more than 35 years, with a passion for nursing education, mentoring and evidence-based practice. Her work focuses on the evaluation and synthesis of evidence for patient care, clinical practice and health care programs. According to her award nominator: “Cecilia’s vision is to translate the evidence so it is meaningful for nurses. She makes the evidence accessible to the people who need it – the nurse and the patient.”
President’s AwardAwarded by ANA\C’s President to a Registered Nurse for
outstanding contributions to nursing.
Linda Burnes Bolton, DrPH, RN, FAAN
Dr. Bolton is Vice President of Nursing and Chief Nursing Officer at Cedars Sinai Health System and Research Institute. Throughout her career, Dr. Bolton has played a vital leadership role in promoting care excellence, patient safety, and diversity in nursing education and practice. Her research, teaching, and clinical expertise includes: nursing and patient care outcomes, improving organization performance, quality care, and cultural diversity within the health professions. In 2009, she was appointed Vice Chair of the Institute of Medicine Commission on the Future of Nursing, which developed the Future of Nursing Report: Leading Change, Advancing Health. Dr. Bolton has served as president for several national nursing organizations including the American Academy of Nursing and the American Organization of Nurse Executives.
ER RN
Oak Valley Hospital District is searching for full-time ER Registered Nurses in Oakdale California. OVHD offers a culture that is focused more on that one on one patient and caregiver experience. If you’re looking for an organization that truly believes in honoring and taking care of its team members which in turn offers excellent patient care outcomes, Oak Valley Hospital District is your employer of choice.
Our full-time RN position offers a competitive salary and excellent benefits. We also offer a pension plan of 15.9% and no cost life insurance at five times annual salary to a maximum of $500,000. Sign on bonuses are also offered.
A little about us, with nearly 550 employees and in a growth mode, Oak Valley Hospital District is a full service, non-profit public hospital created to provide residents of Oakdale, and the surrounding rural communities, with access to superior quality medical care. We also operate four community health centers providing primary care medical services and plan to expand this business as well. As an organization we take care of nearly 90,000 patients a year.
If you’re interested in learning more about what we have to offer and the incredible opportunity
to join our team, please email your resume to Brian Beck,
Vice President of Human Resources, [email protected].
January, February, March 2017 ANA\C The Nursing Voice • Page 9
Marketa Houskova, BA, MAIA, RN ANA\C Government Affairs Director
Congresswoman and registered nurse Lois Capps, who represents California’s 24th Congressional District, was honored with ANA\C’s Public Service Award for her lifelong dedication to nursing and public service during
Rep. Lois Capps Receives ANA\California Public Service Award
ANA\C’s 2016 General Assembly in Redondo Beach. We were beyond excited to have Rep. Capps personally accept this prestigious award during a special ceremony at our President’s Reception.
Rep. Capps worked as a public health nurse and a school nurse prior to launching her career in politics. Rep. Capps is a longtime advocate for nurses and patients, and has
ANA\C 20th Anniversary Celebration & General Assembly
Rep. Lois Capps
(left to right) Legislative Director Liz Dietz, Rep. Lois Capps, ANA President Pam Cipriano, Government Affairs Director Marketa Houskova and President Corinne MacEgan at the
special awards presentation honoring Congresswoman Capps.
educated fellow lawmakers about the critical skills that registered nurses bring to the table as advocates, consensus builders, and problem solvers.
Her most recent accomplishments for the nursing profession include co-authoring the bi-partisan Title VIII Nursing Workforce Reauthorization Act (H.R.2713), and founding the U.S. House of Representatives Nurses Caucus.
While at the ANA\C Conference, Rep. Capps met with ANA\C President Corinne MacEgan and ANA President Pamela F. Cipriano. She dialogued with attendees and members, discussed pressing nursing issues with our Board of Directors and graciously posed for many pictures. She also visited the poster presentations and spoke with their respective authors.
Rep. Capps has been a champion for improving the health and lives of all Americans, especially related to patient safety and care delivery. In a recent blog for The Huffington Post, titled “Once a Nurse, Always a Nurse,” Rep. Capps discussed some of her many accomplishments and memorable
moments as an elected national leader. Since her 2016 announcement about her impending
retirement from U.S. Congress, many people have asked Rep. Capps what she intends to do with her free time. Besides spending time with her family, she said that as a nurse she will be involved in important issues in her community. Once a nurse, always a nurse, indeed!
Corinne MacEgan, MSN/Ed, RN, CHPNANA|C President
During the ANA\C General Assembly, a panel of three nurses: Jimil-Anne Linton, BSN, RN, Kelly Hunt, BSN, RN, and Kathleen Feldman, MSN, RN, described their personal and professional stories of transition into nursing practice. Jimil began the discussion and spoke honestly about her initial transition into the profession, as well as a brief foray into surgical-trauma nursing which was a stark difference from her previous role as a psychiatric nurse. Kelly spoke freely about being a new graduate nurse and her transition from student to professional RN. Kathleen followed with her own story of transitioning from a staff RN to a Master’s prepared nurse specializing in professional development – a switch I personally identified with.
The discussion began in a positive light, but it soon became apparent that a common theme was emerging as each nurse told her story. Kathleen described being treated poorly by someone who should have been a mentor and guide as she entered a new administrative role in her hospital. Kelly related her own dark memories of harsh treatment as a new graduate and as far back as when she was a nursing student. Jimil agreed with the other panelists and enlightened the audience about her own emotional difficulties, not only as a new graduate, but as a nurse transitioning between specialties. The three nurses soon grew emotional as they shared their stories with the supportive crowd.
When the panel opened the floor for discussion, lines formed at the microphones as attendees were inspired to share their stories as well as thank the panelists for their honesty. I took this opportunity to ask the audience how many of them had experienced lateral violence or bullying in the workplace. At least 75 percent raised their hand. When I asked how many had been bullied at some point in life, not just at work, it seemed as if every person in the room raised their hand. Although ANA has a staunch position on lateral violence, the silent display of hands in the air demonstrated that nursing still has a lot of work to do. Every person in the room was engaged in conversation about this important topic, and the session easily could have taken the rest of the afternoon. I hope to revisit this important conversation in a future assembly.
That evening, I had a quiet conversation with our Parliamentarian, Susan Bowman. She addressed the common theme of “nurses eat their young” and suggested
2016 General Assembly Panel: Transitions in Practice
that the ANA\C Board of Directors move to integrate the phrase “nurses EASE their young” into practice. Of course, I agreed with this immediately, and the next day, Vice President Anne Hughes presented the motion to do just that. The Assembly unanimously passed this motion, and we look forward to implementing more education and awareness. I spoke later that week with ANA President Dr. Pam Cipriano, and we agreed to bring the subject forward nationwide for review and presentation.
I wish to thank Jimil, Kelly, and Kathleen for their willingness to be unapologetically raw about their experiences. I also want to thank the attendees at the GA for sharing their stories of workplace bullying and lateral violence – I know it wasn’t easy. There was an absolute bond between each person in the room as we remembered and shared our experiences. I encouraged you then, and still encourage you now, to please send me your stories at [email protected]. We need all of you to help us push the awareness of bullying and lateral violence farther than it has ever been before.
ANA\C members Jimil-Anne Linton, Kelly Hunt and Kathleen Feldman share their experiences during the Transitions in Practice panel discussion
Page 10 • ANA\C The Nursing Voice January, February, March 2017
(2013) Addressing the Penalty for Assaulting Nurses and Other Healthcare Professionals in the Workplace
Still a current issue, being followed by ANA\C; last bill was vetoed by governor in 2015.
Retired Resolutions:
(2009) Support Measures to Prevent Harm Related to Drunk Driving
Successful implementation. Interlock device to prevent drunk driving, implemented law in CA, due to a nurse.
(2007) New Graduate Nurses Residency/Internship Programs
Showing increase of such programs throughout California.
(2007) Strategy to Address Nursing Shortage: BSN Programs Offered by Community Colleges.
Information outdated. Projects were started in 2015.
(2007) Strategy to Address Nursing Shortage: Increase Funding for Faculty Salaries
Information outdated. Ongoing battle, but strategies would need to be readdressed and updated.
(2007) Strategy to Address Nursing Shortage: Offer Funding for the Private Colleges
Information outdated. See previous rationale.
(2007) Strategy to Address Stress, Attrition Rates and the Facilitation of a Broader Student Diversity Base as it Relates to Nursing Schools: Incorporate Support Groups in all California Pre-licensure Nursing Programs
Reports of support groups being encouraged and implemented in programs.
ANA\C Retires Several Resolutions at General Assembly
Zack Huddleston, Chair of the Resolutions Committee presents recommendations during
the ANA\C Business Meeting.
(2005) Strategies to Address the Nursing Shortage
Information outdated. Number of nursing programs have greatly increased since 2005.
(2005) Establishment of a Single California Board of Nursing
Outdated. Ongoing issue, but not seen as a primary issue at this time.
(2005) Use of Simulation Laboratories in Pre-Licensure Nursing Programs
Has been in place, research shows does work, and continues to be used and expanded. 91% of graduates’ report having used simulation.
(2004) Access to Health Care in California
Such access now exists with ACA.
(2004) Uniform Advanced Practice Nursing Titling Language
Outdated. If continued will need much update.
(2004) Nursing Issues and Nursing’s Role in Genetics and Its Therapeutic and Reproductive Applications in Science
2008 founded the G2C2- Genetics/Genomics Competency Center as a resource for classroom and practice.
(2004) Supporting Public Health Nurses and Their Role in Strengthening the Public Infrastructure
Increase has been seen towards public health, including in nursing programs.
(2004) Resolution of Shared Governance and Work Place Advocacy
Outdated information, but improvement has been seen. Shared governance required for hospitals seeking Magnet Status.
ANA\C’s Resolutions Committee reviewed all organizational resolutions and recommended to the membership that two resolutions be continued and several be retired. The membership affirmed the committee’s recommendations at ANA\C’s 2016 Business Meeting during the General Assembly. Thank you to Zack Huddleston and Kathy Melter for their work in reviewing these resolutions.
Resolutions to Continue:
(2014) Healthy Nurse Initiative Support: ANA\California’s Commitment to the Well-Being of Nurses in Our State
Recurrent issue to be followed by ANA\C
ANA\C 20th Anniversary Celebration & General Assembly
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For additional information, please contact Brian Murphy (209) 556-1533
January, February, March 2017 ANA\C The Nursing Voice • Page 11
Mary Ann McCarthy, EdD, RN, CNS, STAH ANA\C Education Director
It is an honor to write my first article as ANA\C’s Education Director!
The fall of 2016 provided a myriad of educational opportunities for nurses at many levels, including nursing conventions, conferences and meetings. The California Nursing Students Association Convention in October was a true educational experience for nursing students. Motivating speakers, informative sessions, advanced practice education information, experience in the parliamentary process surrounding resolutions, and the election of board members were some of the enriching experiences for nursing student attendees. As your Education Director, I oversee ANA\C’s liaison relationships with CNSA, and I am happy to continue this work.
At the ANA\C General Assembly in Redondo Beach, registered nurses from all areas of practice gathered to continue lifelong learning – vital to the future of nursing. I am grateful to all of you who reached out to me at this event and your support of ANA\C educational programs.
Participating in Lifelong Learning ActivitiesA major focus of the joint conference of the California
Organization of Associate Degree Nursing Directors and the California Association of Colleges of Nursing involved discussions with the Board of Registered Nursing including strategies to approve nursing education and expedite licensing of new graduates. Besides representatives from academia, this discussion included the voice of ANA\C as well as many other nursing professionals.
There were a few common themes in each event. One was the Nursing Education Plan White Paper and Recommendations for California. Of the five recommendations in this plan, as your Education Director, I plan to begin conversations through ANA\C around Recommendation III: Faculty Recruitment and Development. How can ANA\C membership help bring this recommendation to life? By planting the seeds of becoming an educator in our nursing students, growing our own faculty, and nurturing/mentoring new faculty in this essential role, we can help address the critical shortage of nursing faculty.
Solving this issue requires multiple voices, including clinical nurses. Clinical nurses can help identify gaps that can be useful in faculty development. Members interested in participating in this discussion can email me at: [email protected]. If you are unable to participate at this time, please email [email protected] so that we may place you on an interest list to update you with the work results as they evolve. Thank you for your commitment to nursing education!
Mary Ann McCarthy, EdD, RN, CNS, STAH
Kathy Falco, MSN, RNChair, ANA\C Bylaws Committee
The California Nursing Students’ Association (CNSA) 2016 Convention in October was an enriching experience for nursing students and recent graduates from across the state. Visalia, the central California location known as the Gateway to the Sequoias, was a serene setting for the event. The energy and excitement throughout the convention was high as members listened to inspiring speakers, gained insights from nurse leaders who reviewed resumes and offered job advice, and visited the exhibit hall to network with vendors, schools and potential employers.
The convention theme, A Culture of Learning: Our Passport to the World of Nursing, reminds these future nurses about the power of knowledge and the exciting possibilities that a career in nursing can hold. Registered nurses often refer to themselves as lifelong learners – this belief adds a deep and profound richness to nursing, because it keeps the profession continuously renewing and reinventing itself.
Having had the opportunity to serve as a CNSA advisor for the past year, I realized that the convention theme also brilliantly describes what the team of advisors, led by CNSA’s Executive Officer Patricia McFarland, MS, RN FAAN, has spent more than a decade actively doing. In fact the work flows so well all year, it can appear that everything happens naturally. However, embedded into every CNSA project, meeting, decision and leadership role is the opportunity for student nurses to build a foundation of continued curiosity, self-discovery and knowledge that evolves the thinking of the nursing student into one of an aspiring nurse leader.
Mentoring Our Next Generation of Nurses
There is so much value when we invest in relationships with the next generation of nurses. One way to take action is through mentoring. So when CNSA advisor, Dr. Susan Bowman, asked me to be an advisor for students elected to the CNSA Board of Directors (BOD) I was delighted. For the BOD student-led projects, I offered guidance, and when opportunities arose for discussion about whether a process was fair and ethical, we talked about standards. I loved supporting the human side of these nursing students. Student nurses have such an intense lens on academics and NCLEX exams, while schools and clinical placements focus on needed technical skills. However, it is
often the non-clinical parts of the new nurse role that are most challenging. Supporting new nurses in the areas of self-care and work/life blending is easier at the beginning of their careers, rather than once they start down the slippery slope of burn out. Also, creating a safe space to discuss real situations a student encountered, that involves power and influence, injustices or cultural differences, is critical for new nurses because it is at a time they can be the most vulnerable.
It has been rewarding to work with the other CNSA advisors to increase the students’ business acumen by running timely and effective meetings (which includes an introduction to Robert’s Rules), providing exposure to financial reports, how-to for budgeting, the decision-making process, relationship building and managing conflicts through respectful encounters, teambuilding and understanding how bylaws guide an organization. One area of focus this past year was to improve communication between BOD members, which remained a high priority throughout this term of office. Mentoring students to develop the soft skills that employers look for and the health care industry needs to promote change, is another move toward professional success.
The days of this past year as a CNSA advisor flowed seamlessly together. Perhaps the greatest lesson learned is the reminder that it takes considerable hard work to achieve good things. So much was accomplished during the 2015-2016 term. It was my absolute pleasure to work with the BOD students who are incredibly impressive. I wish the CNSA students and advisors continued success today and in the future.
ANA\C members Susan Bowan and Kathy Falco at the California Nursing Students Association
Convention in October.
On behalf of ANA\C, Membership Director Phillip Bautista presents a scholarship to nursing
student Joey Nguyen, from Santa Ana College, during CNSA’s 2016 Convention.
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Page 12 • ANA\C The Nursing Voice January, February, March 2017
Liz Dietz, EdD, RN, CS-NP Legislative Director
In every legislative and election year, there is always good news and bad news. Although we did not achieve everything we wanted, there were some major accomplishments in the health policy arena.
More than 3500 bills were introduced in this past 2-year bill cycle and ANA\C followed 47 of those bills. This meant our lobbyist, Roxanne Gould, and our Senior Policy Analyst, Marketa Houskova, were frequently traveling back and forth between our office and the State Capitol across the street. A tremendous thank you to Roxanne and Marketa for their steadfast support of our organization and the nursing profession. A list of those 47 bills and their disposition can be found on our website.
Liz Dietz, EdD, RN, CS-NP
Liz Dietz, EdD, RN, CS-NP Legislative Director
I’m very excited to be back to school as a student and not a teacher! I recently finished my orientation meeting for the American Nurses Advocacy Institute (ANAI) in Washington DC. This program is a great way for nurses, whether novices or experts, to get involved in public policy and advocacy.
ANAI is a prestigious year-long mentored program to develop nurses into political leaders while expanding the
grassroots capacity for the nursing profession and health care. Upon completion, each ANAI fellow is equipped to advise their state nurses association in establishment of legislative/regulatory priorities, recommend strategies for execution of the advancement of a policy issue, and educate members about the political realities as well as assist in advancing nursing’s agenda.
As a more seasoned representative from ANA\C, I had a great chance during the meeting to assist some nurses new to the public policy arena, as well as an opportunity to learn from very seasoned public policy and advocacy nurses.
American Nurses Advocacy Institute: Developing Nurses into Political Leaders
We spent 2016 reviewing and reestablishing policy and procedures for our committee. There are now over 80 members participating on our Legislative List Serve Committee. You can join this committee if you have been an ANA\C member for more than a year and are interested in California legislative and regulatory issues. Submit your name to [email protected] and we will add you to the list.
We have also established a Public Policy Committee that was endorsed and created during the ANA\C General Assembly in October. The committee will consist of 7-9 members appointed by the Legislative Director, who also serves as committee chair, and approved by ANA\C’s Board of Directors. As for all committees, our president will oversee the work of the team. The Public Policy Committee will make recommendations to the BOD related to the introduction of legislation/regulation to be sponsored by ANA\C. The committee will monitor ongoing California legislation relevant to nursing and health care and make further recommendations to the Legislative Committee regarding appropriate actions for ANA\C.
Although the Legislative Committee monitors and supports bills relevant to nursing after they are introduced, the Public Policy Committee will focus on the introduction of legislation and proposed regulations. The Public Policy
2016 Highlights: Legislation, Regulation and EndorsementCommittee, as a smaller body, can more closely monitor changes in legislation and make action recommendations to the Legislative Committee and Board of Directors.
Our Endorsement Committee was reestablished for ten members – five who view themselves as conservative and five who consider themselves liberal. In 2016, the BOD appointed the following members to the Endorsement Committee: Phillip Bautista, Candy Campbell, Mary Ellen Dellefield, Liz Dietz, Donna Dolinar, Anne Hughes, Cathy Melter, Rose Miranda, Corinne MacEgan, and Monica Weisbrich. This group meets by telephone and email.
Last year, the Endorsement Committee made the following recommendations for the 2016 election:
• Assembly Member Bill Dodd for State Senate in Senate District 3 - won this state Senate seat
• Assembly Member Autumn Burke for Assembly District 62 - won re-election
• Proposition 52: Vote Yes to Ensure Federal Dollars Continue to Help Fund Medi-Cal - this initiative passed
• Dr. Bob Derlet, 4th Congressional District - defeated by Tom McClintock
Thank you to our committees and members for your support and contributions to our organization.
We had a chance to practice public relations, media and messaging with differing audiences. There was a session on digital advocacy using Twitter, Facebook, Instagram and LinkedIn. Three excellent nurses helped provide information for navigating Politics 101: Mary Behrens from Wyoming, who has been a town mayor; Janet Haebler a state government affairs staff member from the New York Nurses Association; and Erin Murphy from Minnesota, who is running for re-election to the Minnesota House of Representatives. She is also planning to run for governor of Minnesota in 2018.
The final experience was a visit to the Hill. Yes, members of Congress were in their home states, but their staff were very willing to meet with us. My group also included two nurses from Oregon and Washington, as well as the ANA Political Action Committee lobbyist. We had great conversations with the staff in Senator Boxer’s office, Senator Feinstein’s office as well as Senator Merkley from Oregon.
No nurse is too new or too seasoned to utilize this fantastic program. ANA\C would love to have more members attend ANAI. But the real benefit is truly personal – how you can get energized and learn to utilize the system. The excitement of DC was everywhere.
CliniCal Manager-nursingMust have a BSN. One (1) year of management or supervisory experience. Background in developmental disabilities is preferred.
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Fax: 209-955-3249
email: [email protected]
VMRC is a private, non-profit corporation that contracts with the State of California to provide diagnostic, evaluation, case management, and early intervention services to people with development disabilities.
April 1-8, Yogic Science to Break Habits and Addictive Behavior
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For nearly 50 years, Concorde Career Colleges has prepared thousands of people for rewarding careers in the healthcare industry. We specialize in education with a clearly defined purpose.
Our goal is to prepare students for the most in-demand jobs in healthcare.
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• Meetallofthequalificationsasset forth by the Board of Nursing in the state of employment
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Central Valley Post-Acute (Skilled Nursing)
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January, February, March 2017 ANA\C The Nursing Voice • Page 13
Mary Ellen Dellefield, PhD, RNANA\C Nursing Practice Director
The Code of Ethics for Nurses with Interpretive Statements (ANA, 2015) is the product of a 4-year process that concluded with ANA’s designation of 2015 as “The Year of Ethics.” The code contains nine provisions, accompanied by interpretive statements that describe ethical obligations of all registered nurses (RNs). Provision 3 addresses Advocacy for the Patient. The interpretive statement is: “The nurse promotes, advocates for, and protects the rights, health, and safety of the patient.”1
Some legislation related to patient rights, health, and safety may require that the patient have decision-making capacity. For example, this is one of the requirements of the California End of Life Option Act. All RNs must have the skill to assess a patient’s decision-making capacity. It is likely that the assessment process will be formally defined and implemented by healthcare organizations.
Evidence-based tools exist as aides in the development of a policy and procedure for assessment of decision-making capacity. Prior to this, it is useful for RNs and other clinical staff to recognize common myths about decision-making capacity and work to dispel them. The National Center for Ethics in Health Care (2002) produced an evidence-based report from which common myths were identified.2 These include:
1. Decision-making capacity and legal competency are the same.
2. Lack of decision-making capacity can be presumed when patients go against medical advice.
3. There is no need to assess decision-making capacity unless patients go against medical advice
4. Decision-making capacity is an ‘all or nothing’ phenomenon.
5. Cognitive impairment equals lack of decision-making capacity.
6. Lack of decision-making capacity is a permanent condition.
7. Patients who have not been given relevant and consistent information about their treatment lack decision-making capacity.
8. Patients with certain psychiatric disorders lack decision-making capacity.
9. Patients who are involuntarily committed lack decision-making capacity
10. Only mental health experts can assess decision-making capacity
An assessment of a patient’s decision making capacity must address four concepts. These include: the patient’s understanding, appreciating, reasoning, and stating a specific choice. Deciding may involve a level of risk. Risk is defined as the probability of experiencing a harm or loss. The level of risk associated with the choice will be determined by the condition of the patient and the environment in which the chosen activity is performed. In other words, a patient’s decision-making capacity is contextual. Decision-making capacity is a dynamic characteristic of a patient rather than an immutable one.3-10
These concepts are briefly described. First, the patient’s understanding of the possible outcome of an activity is verified. Next, the patient is asked to express their appreciation of the possible outcomes of the activity, given her actual health condition and physical environment. The reasoning of the patient is explored to verify that the patient has considered alternatives, risks, benefits, and consequences of her decision. Lastly, the patient states the final decision made and the choice that has been made. This assessment process is relevant for both every day and extraordinary situations involving decision-making such as end-of-life care.3-10
Several tools are available for use in assessing a patient’s decision-making capacity. These include: Aid to Capacity Evaluation (ACE)7,11; Hopkins Competency Assessment Test;11 Understanding Treatment Disclosure;11 and MacArthur Competence Assessment Tool-Treatment (MacCAT-T).12 Although not the same, decision-making capacity may be incorrectly referred to as competence, as illustrated in two of these titles.
An evidence-based approach to implementation of the Code of Ethics for Nurses is possible, as suggested by the information presented in this article. References are provided for those readers who wish to further understand what is meant by decision-making capacity and how it is measured. It is important to remember that no objective measure of capacity exists; assessment of this capacity is a judgment made by a group of people who know the patient and have observed her behavior over time.
1. Code of Ethics for Nurses, ANA, 2016.2. National Center for Ethics in Health Care (2002).
Ten myths about decision-making capacity. Veterans Health Administration, Department of Veterans Affairs. (www.ethics.va.gov/docs/necrpts/nec_report 20020201_tne_myths_about_dmc.pdf.)
3. Moye J & Marson DC. (2007). Assessment of decision-making capacity in older adults: an emerging area of practice and research. Journal of Gerontology, 62B (1): 3-11.
4. Kim SYH, Karlawish JHT, Caine ED. (2002). Current state of research on decision-making competence of cognitively impaired elderly persons. The
American Journal of Geriatric Psychiatry, 10 (2): 151-165.
5. Karlawish J. (2008). Measuring decision-making capacity in cognitively impaired individuals. Neurosignals, 16(1): 91-98.
6. Okonkwo OC, Griffith HR, Copeland JN, Belue K, Lanza BS, Zamrini EY, Harrell LE, Brockington JC, Clark D, Raman R & Marson DC. (2008). Medical decision-making capacity in mild cognitive impairment: a 3-year longitudinal study. Neurology, 71(19): 1474-1480.
7. Sessums LL, Zembrzuska H, Jackson JL. (2011). Does this patient have medical decision-making capacity? Journal of American Medical Association, 306(4): 420-427.
8. Simmons SF, Durkin DW, Rahman AN, Schnelle JF & Beuscher LM. (2014). The value of resident choice during daily care: do staff and families differ? Journal of Applied Gerontology, 33(6): 655-671.
9. Sturman ED (2004). The capacity to consent to treatment and research: A review of standardized assessment tools. Clinical Psychology Review, 25: 954-974.
10. Held AR, Eshraghi K, Duntzee CI, Abbott K, Curyto K, & Van Haitsma K. (2014). “It Depends”: reasons why nursing home residents change their minds about care preferences. The Gerontologist doi: 10.1093/geront/gnu040.
11. Joint Centre for Bioethics – Aid To Capacity Evaluation (ACE).
12. Grisso T, Appelbaum PS, Hill-Fotouhi C. (1997). The MacCAT-T: A clinical tool to assess patients’ capacities to make treatment decisions. Psychiatric Services, 48:11.
Promoting the Code of Ethics for Nurses: Assessment of Decision Making Capacity
Mary Ellen Dellefield, PhD, RN
Page 14 • ANA\C The Nursing Voice January, February, March 2017
Continuing Education
We are a busy wellness center in Riverside,
California looking for a Nurse Practitioner.
Please contact Kimberly Arnett, RN at [email protected]
or visit us at
www.MFIRecovery.com
Find your career today!Search job listings in all 50 states,
and filter by location and credentials.
Browse our online databaseof articles and content.
Find events for nursing professionalsin your area.
Your always-on resource for nursing jobs, research, and events.
www.nursingALD.com
Western Multi-State Division
Are you developing educational content? It will probably qualify for CNE* Contact Hours!
We encourage you to use the list below and the flow chart to the left to help you decide if you should apply for ANCC approved CNE!
The following are just some of the many areas that can qualify:
Content related to Direct Patient/Client Care can include but not be limited to:• “In-services” on specific processes in your facility or pertinent to the brand of
equipment, medications, and/or products used in your facility (i.e. monitors, IV pumps, EMR applications, traction, bed alarms, etc.) Will not qualify if taught by a vendor.
• Re-certifications for BCLS, ACLS, PALS, specialty certifications etc. where updatesto current practice standards and re-validation of practice skills are required to maintain competency.
• Courseswheretheprimaryfocusisrecentscientificknowledgeappliedtodirectorindirect patient/client care.
• Patienteducationstrategies.• Certification/recertification skills for BCLS, ACLS, PALS where updates to current
practice standards and re-validation of practice skills are required to maintain competency.
• Specialtycertification/recertificationpreparationcourses• Skillscourses(stomacare,etc.).• Culturalandethnicdiversity• Foreignlanguages(conversational)andsignlanguageforpatientmanagementofa
practice population• Therapeuticinterpersonalrelationshipskillswithpatients/clients• Courses in any specialty area of nursing practice, including occupational health
nursing, school nursing, office nursing, etc. Content related to Indirect Patient/Client Care can include but not be limited to:
• Nursingadministrationormanagement,nursingeducation,ornursingresearch.• Qualityassurancetopics• MedicareandStateRegulationStandards• Legalaspectsofnursing• Teachingmulti-ethnicstudentsandstaff–academicpractice• Retentionofnursesinthehealthcaredeliverysystem,includingcrosstraining• Currenttrendsinnursingandhealthcare• Establishingaprofessionalnursingbusinessorindependentpractice• Publishingforprofessionaljournalsorbooks
Other courses:• Courses that deal with grief, human sexuality, kinesiology, nutrition, crisis
intervention, counseling, stress reduction, burnout syndrome, advanced nursing courses, advanced pharmacology, advanced CPR/dysrhythmia and advanced IV therapy.
*CNE is defined by ANCC as “any learning activity intended to build upon the educational and experiential bases of the professional RN for the enhancement of practice, education, administration, research, or their development, to the end of improving the health of the public and RNs pursuit of their professional career goals.”
CNE content must address a professional practice gap. Professional practice gaps are not limited to clinical practice and may also exist in areas of professional work such as administration, education, and research.
A practice gap can be specific to the setting so ANCC now allows “in- service” topics that were previously excluded. This opens up a wide variety of topics that can meet criteria to be awarded contact hours.
CE = EZ4 UAcceptable Continuing Nursing
Education (CNE) Course Content
*For more information about Conflict of Interest, please visit
westernmsd.org/FAQ
Does your content address an area of nursing practice?
direct patient care/ clinical
practice
indirect patient or client
care such as administration, education, or
research
in-service topics specific to your facility
Your program does NOT qualify for ANCC approved CNE Contact
Hours.
Your content qualifies for ANCC approved CNE. APPLY TODAY!
westernmsd.org
YES
NO
NO
NO
YES
YES
Does it fill a ‘professional practice gap’ in one area listed below?
Does a speaker or planner of your event have the ability to influence or control content for the financial gain of themselves, their employer,
or other healthcare industry business?
It is possible to work with your speaker or planner to resolve the potential
conflict of interest.* Your program may still qualify. Please contact
[email protected] for more information.
January, February, March 2017 ANA\C The Nursing Voice • Page 15
MembershipANA\C Executive Director
Receives Arizona’s Legend in Nursing Award
Robin Schaeffer (center) is honored by the Arizona March of Dimes with their
Legend in Nursing Award.
In 2016, the Arizona Chapter of the March of Dimes presented the Legend in Nursing Award to Robin Schaeffer, MSN, RN, CAE, Executive Director of both the California and Arizona Nurses Associations and co-leader of the Arizona Action Coalition.
This prestigious award is bestowed to a nurse who has dedicated their life to making outstanding contributions to the nursing profession in Arizona. Schaeffer and other nurses whose contributions were deemed exemplary were honored August 27 at the Arizona March of Dimes’ annual Nurse of the Year Awards celebration. 2016 was only the third time the Legend in Nursing Award has been presented in the 13-year history of the Nurse of the Year awards.
“I’m utterly shocked and honored to receive this award,” said Schaeffer. “None of what I do could be done without the help of so many nurses who volunteer their time to work on the initiatives of the Arizona Action Coalition and the Arizona Nurses Association.”
A nurse for more than 38 years, Schaeffer has contributed to multiple nursing and health organizations and participated in health care initiatives at the state and national levels. Through Schaeffer’s leadership, the Arizona Nurses Association has achieved its highest membership numbers and is recognized as a valuable voice in health care decisions in the state. As ANA\C Executive Director, Schaeffer has done a tremendous job leading ANA\C operations and is a valuable resource for the Board of Directors and membership.
“I look forward to using my experience and skills to continue to guide the team of dedicated ANA\C board members and staff to the membership growth and state-based impact they are capable of,” said Schaeffer.
Page 16 • ANA\C The Nursing Voice January, February, March 2017
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