The Alaska Nurse - Vol. 57 No.4 - November 2007

The Alaska Nurse

Circulation 8,000 to every Registered Nurse, Licensed Practical Nurse and Student Nurse in Alaska

Volume 57 No. 4

The Official Publication of the Alaska Nurses Association

AaNA—A Change At the Helm The Alaska Nurses Association (AaNA) has a new Executive Director. Dianne O’Connell, who had been with the organization for over eight years, announced her retirement as of October 2007. After a nationwide search, Tom Renkes, RN, MS accepted the position and will also serve as the labor program director for the organization.

Renkes comes to Alaska from Illinois where he was E.D. of the Illinois Nurses Association.

Prior to that he was E.D. of the Michigan Nurses Association. In addition to nurse executive positions, Renkes has a specialty in mental health nursing and has both taught and published in the field.

Ms. O’Connell plans to remain in Alaska with her husband and write a book on her experiences as a hospital chaplain. Although not a nurse, there is no one who ever portrayed the profession with any higher regard than Ms. O’Connell. She goes with our best wishes on her retirement.

Senator Bettye Davis has introduced SB 28 which would prohibit mandatory overtime and place limits on the numbers of hours registered nurses can safely work before threats to patient safety occurs. The AaNA believes the elimination of mandatory overtime and extended working hours for RNs is a critical step to Kathleen Gettys, improving the quality of RN healthcare and reducing the number of medical errors that occur every year.

SB 28 meets the public policy goal to safeguard registered nurses health and general well being, as well as protecting their patients.

SB 28 excludes any unforeseen declared national, state or municipal emergency or a catastrophic event. SB 28 prohibits an employer from forcing a nurse to work hours in excess of an agreed upon, predetermined, regularly scheduled full-time or part-time schedule unless the employee consents to work and sets a maximum number of hours the nurse can safely practice. SB 28 protects the RNs job and prohibits retaliation against them for refusal to work overtime or reporting employer violations under this law. SB 28 will be enforced by penalties for violations. SB 28 supports nurses who are aware of the perils of long duty shifts and believe patient care would be compromised if forced to work overtime.

Overtime and Staffing In the United States the average number of overtime hours worked annually has steadily increased over the past two decades. Almost one third of the workforce regularly works more

Spotlight ANPA Annual Conference Page 7 Rare Genetic Syndrome Threatens Alaskan Native Village Page 8

Dianne O’Connell, M.Div. retiring AaNA Executive Director pictured with Tom Renkes, RN, MS who assumed her duties October 2007.

Overtime/Long Work Shifts—Legislation Regulating Overtime for Registered Nurses What will SB 28 Really Do?

by Kathleen Gettys, RN

November 2007

than 40-hours a week. It has been no different in healthcare.

Nurses have reported a dramatic increase in the use of overtime as a staffing tool, and fear this jeopardizes patient safety and quality of care provided to their patients. Today, overtime whether voluntary or mandatory is the most common method facilities use to cover staffing insufficiencies. The Institute of Medicine (IOM) has estimated as many as 98,000 hospitalized Americans die each year as a result of errors in their care. The IOM illustrated that mandatory overtime is a serious contributing factor to medical errors. The IOM’s Save a 100,000 Lives Campaign stated, “all overtime by nurses should be eliminated.” A study examining long working hours of nurses in Health Affairs, July of 2004 revealed that the likelihood of making an error was three times higher when RNs worked shifts lasting longer than 12 hours or when they worked more than 40 hours per week.

At one of Alaska’s major medical centers, nurses recognized the potential hazards of long working hours and are in the arbitration phase in order to settle a dispute pertaining to RNs who are not receiving their contractual breaks and lunches. Every time nurses who work 12 hours do not receive their meal periods, they enter in to an extended duty day of 12.5 hours. At the same medical facility, staffing insufficiencies have resulted in the hospital declining vacation requests for most of nurses on a large unit for the months of November and December of this year. Vacation denials have caused RNs to pick up extra shifts to support their coworkers much to the disadvantage of their own personal health and potential dangers to patient care.

Continued on page 9

Statewide Nurses Conference Opens With Call to Political Action Page 11

Inside This Issue President’s Message . . . . . . . . . . . . . . . . . . . . . 2 Editorial . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Back the Future . . . . . . . . . . . . . . . . . . . . . . . . 3 New State Nursing and Federal Regulations on Dietary Supplements . . . . 4 Alaska BON Finds Missing Revenue . . . . . . . 5 Your Address on the Board of Nursing Website . . . . . . . . . . . . . 5 Spotlight Delta Junction . . . . . . . . . . . . . . . . . 6 Spotlight ANPA Annual Conference . . . . . . . 7 Rare Genetic Syndrome Threatens Alaskan Native Village. . . . . . . . . . . . . . . . 8 Membership Application . . . . . . . . . . . . . . . . . 9 RN Safe Staffing Survey . . . . . . . . . . . . . . . . 10 Statewide Nurses Conference Opens With Call to Political Action . . . . . . . . . . 11 2007 Alaska Nurses Association General Assembly Adopts Resolutions . . . . . . . . . 12 Nurses in the News . . . . . . . . . . . . . . . . . . . . 13 Upcoming Events . . . . . . . . . . . . . . . . . . . . . . 13 Resources . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 Letters to the Editor . . . . . . . . . . . . . . . . . . . . 14

The AaNA Vision Empowering Alaska nurses to be dynamic leaders, powerful in both the health care and political communities.

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Page 2—Alaska Nurse—November 2007

Author Guidelines for the Alaska Nurse The editorial committee welcomes original articles for publication. Preference is given to nursing and health related topics in Alaska.

Authors are not required to be members of the Alaska Nurses Association.

Format and Submission Articles should be Word documents in 10 or 12 point font, single or double spaced.

There is currently no limit on the length of the article. Include the title of the article and headings if applicable. Author’s name should be placed after the title with credentials, organization/and or employer and contact information. Authors must identify potential conflicts of interest, whether of financial or other nature and identify any commercial affiliation if applicable.

All references should be listed at the end of the article. Pictures in black and white

or color are encouraged and may be sent as a jpg. file, as an email attachment or on disc. Photographs sent to the Alaska Nurse will become property of the AaNA. We hope that we will be sent copies, not originals and prefer emailed files. Be sure to spell check, grammar check and second check the article, any website addresses, references or phone numbers. It is recommended you have a colleague review your article before submission.

Prepare the article as a WORD document and attach it to an email to editor@aknurse. org. If you do not have WORD, try pasting the text of the article directly into the body of the email. You may also mail the article on disc to Editor, AK Nurse, Alaska Nurses Association, 3701 East Tudor Road Ste 208, Anchorage, AK 99507. If you have any questions email the Editor, Lynn Hartz at lhartz@alaska.com.

President’s Message Debbie Thompson BSN, RN, CNOR It has been my privilege to serve as the face of nursing in Alaska this past year. Our profession is one of the most trusted professions recognized today and I believe with that comes a great responsibility no only to my fellow nurses, but also to our patients/clients and ultimately to the public that we serve. It is by being an active participant in our profession that we can serve those affected Debbie Thompson by the practice of nursing. It is BSN, RN, CNOR in doing our jobs to the best of our ability and for taking the responsibility for the safe practice of nursing and patient handling that we participate. We do this each day that we report to work and do our jobs. My goal is that each of us will take a more active and participatory role in nursing. By doing this we can stand ready to stop those who try to influence how we practice at each of our jobs and the outcomes this can have for our patients or clients.

The fi rst place that I have served as your representative is at the Board of Nursing meetings at the state level. These meetings are held quarterly and the issues and decisions that this board makes impacts how you and I are able to practice our profession. It is in knowing the changes and the topics that come to the Alaska Board of Nursing that we can protect our job and our ability to do our jobs.

It must be understood that the board of nursing was formed for the protection of the public, not necessarily the protection of nurses. With this in mind, one of the fi rst things that the AaNA board and I want to project is that AaNA is the go to place for nurses when they have a question about nursing and their safety and safe practice. Small victories seem to happen, we receive calls from law makers asking our opinion on issues..

Two position papers were authored by the Professional Practice Committee: one on nurse administration of Dietary Supplements and one on Nurse supervision and delegation of EMT students. Both of these position papers impact how nurses practice and can be found on the aknurse. org website, I encourage each of you to read these position papers and make sure that you are practicing within the RN scope of practice. It is a good example of defining our own practice based

on the evidence.

I have represented nurses and our goals at the legislature and have testified and monitored testimony for the bills that AaNa has chosen to either promote or follow with support and action during the legislative sessions. I would like to again encourage each one of you to become an active participant in the legislative process and watch what the legislators are doing and how it can impact our practice. Each time I am in Juneau and see legislators, I am reminded that the physical presence of nurses is needed to not only to monitor impact on our profession and how we practice, but to monitor and be aware of those situations that can impact to ability of the public to have access to good healthcare. Together we have a clear strong voice that makes sense to law makers, not a confused “I think this is how it works for healthcare.” Take the time to think about becoming a legislator; we need more nurses in Juneau to help make broken systems work again and to guide those who make decisions about healthcare and do not know how it impacts the practice of nursing or how the public receives care.

We need more nurses leading, not reacting.

I have been asked to talk at different nursing conferences and celebrations and do so with great pride as I have used my personal belief that we as nurses have the power to affect positive change and to impact our own Profession. In order to do this, I truly believe that we need to stand together shoulder to shoulder united in our belief that safe patient and safe nursing handling are our priorities. My belief is that is does not matter who our employer is, what our job title is, whether we are staff nurses, advanced practice nurses or management, we are the ones that need to stand together and make sure that we are heard with one united voice for the empowerment of allowing each of us to practice nursing.

As we start a new era at AaNA, I would like to take this time to thank Dianne O’Connell for her leadership, guidance and genuine concern for the nurses and nursing practice in Alaska and wish her well in her retirement. As we move into a new era, I like to welcome Tom Renkes RN, MS to Alaska and to AaNA and wish him the very best in leading AaNA and Alaska nurses to places we have dreamed of but not yet traveled.

I would like to thank each of you for your trust in me to represent you as a strong voice for nurses and for our nursing practice.

Respectfully Submitted Debbie Thompson, BSN, RN, CNOR President, AaNA

An official publication of the Alaska Nurses Association, 3701 East Tudor Rd., Ste. 208, Anchorage, AK 99507. Tel: 907/274-0827. Web site: www.aknurse.org. Published quarterly.

Materials may not be reproduced without written permission from the Editor. Views stated may not necessarily represent those of the Alaska Nurses Association.

Editor: Lynn E. Hartz, MSN, FNP lhartz@alaska.com AaNA Board of Directors President: Debbie Thompson BSN, RN, CNOR Vice President: Nancy C. Davis, RN, MSN Secretary: Michelle Murphy, RN Treasurer: Martha Clinehens, RN Directors: Labor Council Chair: Donna Phillips, BSN, RN Greater Alaska Director: Sara M. Harvison, RN, BSN Staff Nurse Director: Kathleen A. Gettys, RN, BSN, BA Rural Director: Jane A. Conard, RN Director at Large: Carolyn S. Adkins, RN, MS, COHN-S, CM, COHC Paul T. Mordini, RN Dara M. Whalen, RN, MS AaNA Labor Council Chair—Donna Phillips, RN, BSN Joseph Peacott, RN, OCN Joshua Meals, RN, ADN Deni Callahan, RN Jenni Hancock, RN Julie Torres, RN UAN Rep.—Kathleen A. Gettys, RN, BSN, BA PAMC BU Rep.—Marlene Brehmer, RN Soldotna BU Rep.—Steve Baumgardner, RN Ketchikan BU Rep.—Susan Walsh, RN Affiliate Organizations: Alaska Chapter of the American College of Nurse Midwives Alaska Nurse Anesthetists Association Alaska Nurse Practitioner Association Alaska School Nurses Association Forensic Nurses Association, Alaska Chapter Executive Director: Tom Renkes, RN, MS Advertising Rates Contact—Arthur L. Davis Publishing Agency, Inc., 517 Washington St., P.O. Box 216, Cedar Falls, IA 50613, 800-626-4081. AaNA 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.

Greetings from our house to yours.

Happy Holidays from The Alaska Nurse!

November 2007—Alaska Nurse—Page 3

Editorial

by Dianne Tarrant, FNP President, Alaska Nurse Practitioner Association

Tom Renkes, Executive Director and Labor Program Director for the Alaska Nurses Association.

Back the Future

by Tom Renkes, RN, MS Well, I’m here. Back where in 1958 my parents didn’t have enough money to buy a new tire so they could drive out of Anchorage. Back when my picture in front of Portage Glacier actually shows the glacier. It’s all happened so fast.

I fi rst want to publicly thank my colleagues in Michigan, Illinois and the UAN. There are some heroic people out there doing some heroic things for nurses all over the country. If it wasn’t for them I wouldn’t be here now.

Now Alaska. Chapter III. I’m sitting at the Peanut Farm eating breakfast and watching football before Mass. Anchorage just keeps growing doesn’t it? (The Green Bay fans are loud.) Yesterday I ventured up to the Palmer Pioneer/Vet’s Home and the new Valley medical center. Two weeks prior, I took a ride around the Kenai Peninsula to see all the health care facilities down there. My hope is to make regular visits to all the health care facilities, clinics and care centers throughout Alaska.

Why? The vision of your Alaska Nurses Association should be to make every professional Registered Nurse in the State of Alaska feel the respect and dignity you so deserve as a professional RN. We can’t always control or explain your working environment for you, but the self worth as a professional that makes you want to “be” is something we can help with. That’s what a health professional association is all about.

Health care and wellness do not happen without the professional RN. Every person, family and community that achieves wellness is touched by a professional RN. That is you. That is the glory and sometimes troubling path to that altruistic goal you chose to make a mark on this society—and you do leave your mark. Whether it’s the 7 pound bouncing boy in McGrath, the 90 year old veteran in Palmer, or the young teacher who flipped her car outside of Fairbanks, you do leave a mark.

Every nurse is a hero every day. That’s why I’d like to visit everyone. I’d like to hear from you what we can do to help you in your professional life. Work is hard enough: more patients; more paperwork, more people telling you what to do and how to do it.

There’s no guarantee that AaNA can fi x your work site or working conditions, but often fi xes aren’t that difficult when you ask someone to help. You’re a hero, but you also have to take care of yourself. After 34 years in health care, I have learned how to do that, now it’s time to give back.

Shortages in access to primary health care services in Alaska have been, with increasing frequency and urgency, receiving more and more attention by the public and our legislators. Numerous articles and commentaries have been written and high level meetings held focusing on how to resolve the shrinking number of health care providers, namely family practice physicians, available in the state to serve the growing health needs and disparities of our communities. To date, there has been little mention of the role nurse practitioners play in the resolving the problems of access to care in our state. In addition, there has been a dearth of information about NP practice in Alaska.

A survey was undertaken in the spring of 2007 by the Alaska Nurse Practitioner Association to assess nurse practitioner practice in the State of Alaska in order to rectify this lack of information. The following is a synopsis of our findings.

A total of 465 NPs licensed and living in Alaska were polled. A total of 182 NPs Dianne Tarrant, FNP responded to the survey (response rate of 39%). One hundred eighty NPs completed the survey questions.

Almost 75% of NPs practice in urban areas, while over 31% practice in rural areas. Some NPs practice in both sites. Of NPs who practice in rural areas, 12.3% are located in subregions, such as Bethel or Kotzebue. Nine percent work in clinics on the road system and over 12% work in clinics off the road system. Almost 2% work in remote areas. In addition, 7.6%, (N=13) of NPs are the sole licensed providers in their communities and 26.5%, (N=45) of NPs practice in medically underserved areas.

NPs in Alaska contribute significantly to the primary care needs of our state. An NP in Alaska averages 1884 primary care visits per year which translates to a total of 825,192 primary care visits per year (based on a total of 438 NPs who provide primary care services).

There has been much angst about the lack of particularly Medicare and also Medicaid providers in Alaska. When we looked at NP practices, we found that 76.4% of NPs accept Medicare reimbursement for services and 86.3% of NPs accept Medicaid reimbursement for services.

We also found that NPs focus much of their care to the underserved. The following table illustrates this point.

NPs care for the underserved Minority Group African American AI/AN Asian/P Islander Hispanic/Latina Other Uninsured <100% Poverty Level Not Fluent in English

Average % of Practice 7.8% 30.5% 7.7% 6.9% 3.5% 35.0% 43.2% 9.1%

% of Alaska Pop. 3.7% 16.0% 5.2% 5.1% 19.0% 11.2%

Nurse practitioners have existed as a profession for over 40 years. Nurse practitioners have been practicing independently in Alaska for almost 24 years. The majority of nurse practitioners who practice in Alaska are family nurse practitioners. Other specialties include adult health and illness, pediatrics, women’s health, psychiatry gerontology, acute care, and some subspecialties. Nurse practitioners are filling the void in all aspects of primary health care. With the decline in numbers of physicians opting for careers in family practice, nurse practitioners are stepping up to the plate in increasing numbers to provide those needed services and in a very high quality and cost-effective manner.

New funding has been provided by the legislature to double the number of medical students from Alaska entering the WAMI Program. While it is important to provide support and incentives for future physicians, we believe it is equally important to support and fund nurse practitioner education. We should be enlarging the nurse practitioner educational program in the state, at the University of Alaska Anchorage. This is the only statewide program that offers a total educational package for complete training of primary care providers within the state. In addition, incentives should be provided for nurse practitioners outside of Alaska to come to the state to practice. We should be looking at even more ways to increase the numbers of nurse practitioners practicing in Alaska. It is time for us as nurses to fully recognize and support nurse practitioners in the critical role they have taken to decrease health disparities and provide services to all populations in our state.

Page 4—Alaska Nurse—November 2007

Notice - New ANA Dues Rate The 2004 ANA House of Delegates passed an automatic dues escalator that increases the ANA Assessment Factor based on the Consumer Price Index (CPI-U). The rate change is computed using the 12 months percentage change from June to June each year.

The computation is made each year, but the policy states that the increase is only to be made every three years. The first rate increase went into effect January 2005.

The next increase is slated for January 2008. This increase will be $8.00 per year and applies to both collective bargaining and non-collective bargaining members.

If there are any questions, please call Tom Renkes, RN, MS, and AaNA Executive Director at 907-274-0827.

New State Nursing and Federal Regulations on Dietary Supplements The Alaska State Board of Nursing adopted regulations regarding nurse administration of nonherbal nutritional supplements at it’s June meeting in Anchorage, Alaska. The regulations are included in this issue of the Alaska Nurse and can be accessed with the complete Alaska nursing statutes and regulations at www.dced.state.ak.us/occ/pnur.htm.

In a related story, the August issue of the Tufts University Health & Nutrition Letter reports that the US Food and Drug Administration (FDA) is phasing in a long-awaited rule requiring that supplement makers test their ingredients for contaminants and potency. The move came after the agency found undeclared active ingredients in some supplements and shortages of amounts of vitamins versus amounts stated on the label in other vitamin supplements. Companies will be allowed up to three years to comply.

Alaska Board of Nursing New Regulations in effect August 30, 2007 12 AAC 44.945. ADMINISTRATION OF A NON-HERBAL NUTRITIONAL SUPPLEMENT. (a) A nurse licensed under AS 08.68 may administer a non-herbal nutritional supplement to a patient if (1) the patient’s health care provider has ordered that the non-herbal nutritional supplement be administered to the patient; (2) the patient or the patient’s representative has requested that the nurse administer the nonherbal nutritional supplement to the patient; (3) the nurse administering the non-herbal nutritional supplement knows the actions, possible side effects, and possible interactions of the non-herbal nutritional supplement with food, medications, or other substances; (4) the use of the non-herbal nutritional supplement is included as part of the nursing care plan for the patient;

(5) the non-herbal nutritional supplement was commercially manufactured and the container of the non-herbal nutritional supplement provided for administration to the patient was provided unopened with the manufacturer’s seal intact; and (6) a pharmacist has reviewed all medications taken by the patient and the non-herbal nutritional supplement ordered by the patient’s health care provider for possible adverse effects or interactions with food, medications, or other substances. (b) The administration of a non-herbal nutritional supplement may not be delegated by a nurse under 12 AAC 44.950-12 AAC 44.965. (c) A nurse licensed under AS 08.68 may not administer to a patient a nutritional supplement that (1) contains one or more herbs; or (2) was compounded for the patient rather than commercially manufactured. (d) This section does not apply to United States Food and Drug Administration (FDA) approved vitamins and minerals.

A nurse licensed under AS 08.68 may administer FDA-approved vitamins and minerals to a patient in the manufacturer’s recommended dosage or as ordered by the patient’s health care provider. (e) As used in this section, (1) “administer” means to provide a nutritional supplement to a patient for ingestion by the patient; (2) “compounded” means the preparation, mixing, assembling, packaging, or labeling of a nutritional supplement; (3) “health care provider” includes a licensed (A) advanced nurse practitioner; (B) doctor of medicine; (C) doctor of osteopathy; (D) physician assistant; and (E) dentist; (4) “herb” means a plant grown for its health or medicinal properties; “herb” includes plant parts and extracts; (5) “non-herbal nutritional supplement” has the meaning given for a “dietary supplement” in 21 U.S.C. sec. 321(ff) (sec. 3(a) of the Dietary Supplement Health and Education Act of 1994) as revised as of March 1, 2007, adopted by reference, except that it does not include a dietary supplement that contains one or more herbs; (6) “nutritional supplement” has the meaning given for a “dietary supplement” in 21 U.S.C. sec. 321(ff), (sec. 3(a) of the Dietary Supplement Health and Education Act of 1994) revised as of March 1, 2007, adopted by reference.

Authority: AS 08.68.100 12 AAC 44.970. NURSING DUTIES THAT MAY NOT BE DELEGATED. Nursing duties that require the exercise of professional nursing knowledge or judgment or complex nursing skills may not be delegated. Nursing duties that may not be delegated include (14) administration of a non-herbal nutritional supplement.

Authority: AS 08.68.100 AS 08.68.405 AS 08.68.410

Alaska Board of Nursing Finds Missing Revenue Cathy Giessel, MS, RN, ANP, FAANP, Chairperson, BON Many nurses think that the Board of Nursing (BON) determines the fees for licenses. This is actually not true. The fees are set by the Division of Corporations, Business and Professional Licensing, under which the Board operates. State law mandates that regulatory boards must be self-supported by the fees of their licensees. The financial managers of the Division examines each Board’s revenues and expenses, and then uses this analysis to set the fees for that Board’s licensees.

So, if the Board of Nursing budget does not balance, nursing license fees would be increased accordingly.

The Alaska Board of Nursing takes very seriously its many responsibilities, one of which is fiduciary. The Board reviews its revenue and expenses at each quarterly meeting. About two years ago, the Board noted decreasing revenues in the Board’s budget. This made no sense, in light of the fact that more nurses are being licensed in Alaska. Questions were asked of the financial managers but no answers to our questions were forthcoming.

At the March 2007 meeting, the Board was alarmed to see a continued and even more significant decrease in revenues. It was particularly evident since the license renewal cycle had just completed at the end of 2006. This is the time that the Board should have the highest revenue income. But revenue was decreased! It was then that the Board insisted that the financial managers of the Division explore this in detail and give us an explanation.

And the answer was found. At the June 2007 meeting the Board was informed that the coding

for on-line license renewals was incorrect. While more and more of our licensees chose the ease and expediency of on-line license renewal, the financial department had not created a coding category for the fees coming in through this method of license renewal. Therefore, those monies were not being credited to the Board of Nursing.

As a result of this discovery, and its correction, the Board of Nursing was credited with over $1.7 million in revenue from the 2004 and 2006 online license renewals. This put the Board back into a balanced budget position. And the finance department coding deficiency was corrected.

The Board of Nursing was not the only entity affected by the coding error. The Board of Medicine and several other professional regulatory boards had also experienced declining revenues.

However, the Board of Nursing was the entity that recognized the problem and persisted in asking for an explanation, resulting in discovery and correction of the coding error. Other Boards are benefiting from the discovery, with additional revenue from their on-line license renewals.

On-line license renewal is a very popular service by Division of Corporations, Business and Professional Licensing. The Board of Nursing is happy that so many nurses chose this method of license renewal. And now we are assured that the revenues will be properly coded and credited to the Board of Nursing.

The effect of locating the error and the missing revenue on nursing license fees for 2008 is not yet known. The Division’s financial analysis will be done at the end of Fiscal Year 2008, and the license fees will be determined at that time. There is no way to predict whether license fees will go up until the analysis is completed.

November 2007—Alaska Nurse—Page 5

Your Address on the Board of Nursing Website >emails from Nancy Sanders, PhD, RN, >Executive Administrator Hello again, I continually field questions about why nurses’ addresses are able to be looked up through the professional licensing search on the website.

There is a great deal of concern expressed by many licensees about this practice. Let me explain.

The licensing information that can be found on the website is public information. This is a case of the internet exacerbating a problem that already existed. Prior to the internet, a person could request the information from this office. However, it was not as available as it is now.

Two pieces of information you should know.

There is a lawsuit that has been heard asking for the removal of addresses from public display on the professional licensing search part of the website. The public could still find out if someone is licensed and whether the license is current. We are awaiting a decision in that case. Second, even though you are required to keep your address current with the Board of Nursing, you can list a work address or post office box instead of a physical address. Be aware that the addresses are used to send renewal information and that it is the licensee’s responsibility to keep the address up to date. If you would like to change your address, there is a change of address form on the website that you can fill out and sign. Send it to: Board of Nursing, 550 W. 7th Ave., Suite 1500, Anchorage, AK 99501. A fax is also acceptable with your signature included. The fax number is 907-269-8196.

There is no charge for address changes. >Thank you, Nancy >Alaska Board of Nursing >907.269.8161 >nancy.sanders@alaska.gov

Page 6—Alaska Nurse—November 2007

Spotlight Delta Junction

by Janice Templin-Weller, PHN I work for the State of Alaska in a small Public Health Center in rural Delta Junction. I have been a public health nurse for this community since 1982. In the Fall of 2006 I received a grant from the Alaska Nurses Foundation to prepare and present a parenting class for our community.

Through the many experiences I have had with families over the years, and through raising my own three daughters, I know how important the role of parenting is. I also realize that parenting requires constant learning and evaluating. This is often done informally with friends and family, especially in a small town where there are not the variety of resources for parenting support and education.

The fi rst parenting class in our community began when my girls were preschool age and I worked part time. A group of friends and I decided that we needed to get together somewhere to let our children run and play and work off some energy during the dark and cold winter months. We arranged to use the community center and developed the fi rst community “play group.” This was quite a success. As our children played we found ourselves sharing frustrations of parenting and ideas for dealing with challenging behaviors. This peer support was immensely beneficial and the group quickly developed into not only a play group, but an informal parenting group. Then through my position as a public health nurse I continued to offer parenting groups a few times each year.

As my job with public health became more involved with other priorities the parenting classes got put on the “back shelf.” It has been years since I taught a parenting class, but after attending a Dr. T. Berry Brazelton seminar I became inspired to spend more time with families to educate them about the incredible gift and responsibility they have in parenting their children. At about the same time I became aware of the grant opportunity through the Alaska Nurses Foundation. This was just the push I needed to start a new parenting class and develop a lending library of parenting books.

After searching for parenting resources to use for the class I decided on the series by Adele Faber and Elaine Mazlish,—“How to Talk So Kids Will Listen.” The parenting series comes with a DVD, a teacher’s guide, workbooks, and resource books for the class. I also supplemented the information with Dr. Brazelton books on child development,

and began putting together a lending library of parenting books and videos, as well as books on child development.

Publicity for the parenting series was done through the local newspaper, radio, church groups, social services, refuge assistance program, library, flyers, and word of mouth. There were several challenges in getting this parenting class going. I did not get a good response the fi rst time, and postponed the start of the class. I found that parents of preschool age children were quite busy with activities such as library story hour and a mother’s support group, as well as other commitments with older children and school activities. After a second round of advertising and

outreach through the mother’s support group there was enough response to start a class.

Babysitting was offered through the grant funds.

I used 4 teens from the local home school program for babysitters during the parenting classes. An eight hour Red Cross CPR class was taught by a local instructor and offered to all of the teens. Two of the teens took the class and received their CPR cards.

The parenting class was held at the community center, which was able to be divided for a play area for the children and a parent area for class and discussion.Each participant was given the books “Liberated Parents, Liberated Children—Your Guide To A Happier Family,” and “How To Talk so Kids Will Listen and Listen So Kids Will Talk,”

by Adele Faber and Elaine Mazlish, as well as a workbook to use with the parenting classes.

The parenting series covered the following issues: 1. Dealing with children’s feelings 2. Engaging cooperation 3. Alternatives to punishment 4. Encouraging autonomy 5. New ways to praise 6. Freeing children from playing roles Six mothers registered for the parenting series, and 4 moms made all 6 sessions. There were 13 preschool age children between the 6 mothers.

Although this may seem small, it is a good successful start for a small community like Delta Junction.

Response to the class was very positive. The feedback from evaluations indicated that the structure of each class made it easy to focus on one specific parenting skill, the atmosphere was comfortable and encouraging for sharing successes and problems, and the babysitting was a great help. It was amazing to hear the parents share their ideas and insights gained from the classes. The following responses and outcomes were collected from the evaluation forms as things learned or done because of the class: 1. Communication with children was more effective and helpful 2. Resolved conflict by using the steps of problem solving learned in the class 3. Strengthened a child’s sense of autonomy by encouraging him to use his own judgment and resources 4. Learned to use an alternative to punishment in correcting a behavior 5. Successfully used one or more of the methods from the class to engage cooperation 6. Learned to acknowledge a child’s feelings and to express negative feelings without attacking the child’s character 7. More often let child solve as much of their own problems as possible before stepping in to help Plans for future parenting classes include having a “brown bag” parenting series to meet once a month at lunch time, coordinating referral to the parenting class through the State of Alaska Office of Children’s Services, and presenting parenting seminars through the Delta Greely School District Parent Teacher Student Association.

The Alaska Nurses Foundation grant funds have been extremely helpful to get this parenting class started, and the materials purchased with the grant funds will be beneficial for use in future classes, seminars, and for the lending library for years to come.

November 2007—Alaska Nurse—Page 7

Spotlight ANPA Annual Conference The 23rd annual conference of the Alaska Nurse Practitioner Association (ANPA) was held in Anchorage, Alaska, September 13 through 15, 2007. A record number of 170 participants attended representing 36% of the nurse practitioners estimated to work in the state [AK Nurse vol 57,no3]. Three clinical tracts covered a wide spectrum of subjects, which were chosen based on the previous year’s feedback.

One of the highlights of the conference was presentation of the ANPA Nurse Practitioner of the Year Award to Connie Judd, MSN, ANP. NP Judd came to Alaska in 1982 and worked as a village health aide. She became interested in mental health nursing as a way to help traumatized patients. She earned her BSN in 1976 and a MSN in Psychiatric /Mental Health Nursing in 1992. Ms. Judd has affected health care throughout Alaska through her work with village health aides and teaching at the University of Alaska, Anchorage. She currently maintains a busy mental health practice with Advanced Medical Centers of Alaska in Wasilla.

The conference for next year is at the Marriott in Anchorage September 25-27, 2008. Conference chair is Martha Herriott, at mherriott@aol.com.

ANPA President Jill Barnes presents Connie Judd, MSN, ANP with the 2007 Nurse Practitioner of the Year award.

Jennifer McGrath BSN, ONC, helping out at the registration booth, later found out she was the recipient of the $1,000 ANPA Educational Grant awarded to one graduate student annually based on academic achievement and planned contribution to the nursing profession.

Fifty exhibitors representing drug companies, non-profit groups and a variety of health-care organizations allowed practitioners, some from rural areas off the road system, to get patient education materials, updates on medications and information that otherwise might not be available to them.

Bethany Buchanan, ANP, owner of Avante Medical Center, past ANPA president and current ANPA web-queen enjoys chamber music in the evening with daughter Serena Sky.

Page 8—Alaska Nurse—November 2007

Rare Genetic Syndrome Threatens Alaskan Native Village

by Donna Fenske, MSN, FNP “A rare genetic syndrome threatens future generations in an isolated Alaskan Native village” is an excerpt out of the research done by Donna Fenske. She defended her thesis entitled “Alaskan Village Adults’ Understanding of Thiamine Responsive Megaloblastic Anemia,” and graduated from UAA in December 2006, with an MS in Nursing and her Family Nurse Practitioner.

No studies have been done on TRMA from a nursing perspective.

Thiamine Responsive Megaloblastic Anemia (TRMA) is an autosomal recessive condition that presents with three cardinal symptoms: anemia, diabetes and deafness. There can also be cardiac and vision involvement. First identified in 1969, it is extremely rare, occurring in less than 70 people in the world and in 19 world locations, including five in the United States (AK, CA, IA, NC, NY). The most cases in one geographic area are in an Alaskan village. It is strongly suspected that three children who died as infants in the late 60’s—early 70’s had this condition.

Medical research started in Alaska in 1987 when a Genetic Researcher/Harvard Medical Professor (Dr. Ellis Neufeld), an expert in the field of TRMA research, contacted Donna, then a public health nurse for the State of Alaska. Having

worked with five children with this condition, four of them occurring after starting as a PHN in 1979, she wrote to the authors of an article on TRMA written by two Lebanon physicians searching for any answers to this rare occurrence. As a result of this correspondence, several years later the Lebanon physicians came to the US bringing the letter they received from Donna and gave it to Dr. Neufeld. That is how this collaborative research began and continues to this day. She identified TRMA in a sixteen month old a year ago during a clinic appointment. It has reoccurred in another generation.

As a result of much of the research done, with the support of the village leaders and the people, a carrier test has been identified. The anemia only responds to thiamine.

Of the three billion letters in the genetic code, one is missing in thiamine mutation, thus does not make a protein transporter resulting in lack of thiamine, or TRMA syndrome. There is no cure.

Note: This is not Donna’s fi rst time “back to school” in her professional career. She has also earned a Masters of Art in Education and a Masters in Public Health. She is now practicing as an ANP in rural villages and plans to find grant funding to do carrier testing on high risk and at risk individuals and to implement strategies and interventions for education and prevention, learned from the participants of her research.

UAA August Graduates In August, the following students graduated from the University of Alaska, Anchorage School of Nursing. The Alaska Nurses Association would like to take this opportunity to give you a warm (if belated) welcome to the profession and congratulate you on your achievement!

BS Program graduates Aug 07: Heather R. Andersen Nicole M. Lanners Jennifer A. Anderson Shannon A. Lee Sinnamon M. Bovey, RN Jennifer A. Lemon Alison L. Burks Kathleen J. Libke, RN Krista J. Card Kelly B. Marshall Anna J. Dickerson Shawna L. Martinez Brian E. Erdrich, RN Gryceyda Melgar Emlynne S. Escalante Jacqueline Nikki Nikodym Joyce E. Fulton Lisa A. Ostoj Elizabeth D. Geest Rachel G. Robinson Robert Phil Herndon Anne Marie Rosazza Kendra L. Jaten Jeanne A. Sponsel, RN Jessica J. Kelley Kelsey A. Sturrock Patricia A. King Christi L. Swanson Ruth A. King Holly R. Thompson Aubrey B. Knapp Catherine A. Troutman Deborah J. Koelsch, RN Carey S. Werlein Stephanie A. Lamb Graduate Program Graduates MS Graduate—Thesis Cheryl M. Milline, Health Care Administration Chair- Dianne Toebe, Ph.D. “Knowledge Regarding Sexuality in the Elderly in Nursing Staff of a Long-Term Care Facility” MS Graduate—Project Bernadette M. Weldon, Health Care Administration Chair- Jill Janke, DNSc “Providence Chart Evaluation: Nursing Attitudes Toward Computerization”

November 2007—Alaska Nurse—Page 9

Overtime/Long Work Shifts

Membership Application

Continued from page 1

Advancing and Supporting the Profession of Nursing Integrity Professionalism ~ Advocacy Empowerment~ Representation

Membership Categories

Full Membership—Employed Full-time or Part-time Reduced Membership—Not Employed * EDPP is the monthly Electronic Dues

Full time student Payment Plan Amount

New graduate from basic Nursing Education program, within first six = Yearly dues/12

months after graduation (first year only), or months + $.50 per

62 years of age or over and not earning more than Social Security allows. month service charge Special Membership—Not employed and 62+ years or totally disabled

Dues Anchorage Monthly (*EDPP) & Fairbanks Yearly

Full $28.00 $330.00

Reduced $14.25 $165.00

Special

$7.38 $82.50

All Other Yearly Locations Monthly (*EDPP)

$322.50 $27.38

$161.25 $13.94

$80.62 $7.21

_______________________________________ _________________________________________________ Last Name/First Name/ Middle Initial Social Security Number _______________________________________ _________________________________________________ Street or PO Box City/State /Zip Home Phone _______________________________________ _________________________________________________ Employer Name Unit City/State/Zip Work Phone _____________________________ RN License Number/State

___________________________ FAX Number

__________________________ E-mail Address

Payment Method—see above for categories and amounts

Apply Online at www.nursingworld.org—Join Today! Alaska!

Check—Please make checks payable to the American Nurses Association MasterCard or Visa—(available for annual payment only)

Return application and payment to: AaNA 3701 E. Tudor, Suite 208, Anchorage, AK 99507

________________________ _____/_____ $_______ _______________________________ Card Number

Expiration Amount Signature Monthly Electronic Dues Payment Please (1) read and sign the below authorization form and (2) enclose a check for the first month.

1/12 of your yearly dues will be withdrawn from your checking account monthly along with a monthly service fee.

AUTHORIZATION to provide monthly electronic payments to the American Nurses Association (ANA): This is to authorize ANA to withdraw 1/12 of my annual dues and any additional service fees from my checking account designated by the enclosed check for the first month’s payment. ANA is authorized to change the amount by giving the undersigned thirty (30) days written notice. The undersigned may cancel this authorization upon receipt by ANA of written notification of termination twenty (20) days prior to the deduction date as designated above. ANA will charge a $5 fee for any return drafts.

________________________________________

Signature for EDPP Authorization

Integrity ~ Advocacy

Professionalism Empowerment Representation

Share your Expertise!

Get Informed! >>check off and return form to AaNA

A Benefit of Membership: AaNA Member Name: __________________ E-mail: ________________________________ Informational E-mail ❏ Various Nursing Information—If you would like National, State and Local nursing information e-mails from AaNA on a weekly basis. ❏ Action Alerts—If you would like political action alerts for National and State legislative issues involving nursing and health care issues.

Taskforce E-mail Pools Taskforce E-mail Pool members will receive requests to work on a variety of projects on nursing issues, and may choose to participate in only the projects that interest them. ❏ Professional Nursing Practice Issues— Taskforces will consider issues relating to AaNA’s policy on RN practice and other professional issues. ❏ Health and Safety Issues—Taskforces will consider safety and health issues of nurses and patients. ❏ AaNA Event Planning—Taskforces will plan events such as the AaNA Fall Retreat, open house events, AaNA General Assembly, or other events for AaNA members. ❏ Other interest? Let us know what you would like to work on:______________ AaNA Committees ❏ Legislative Committee—Actively involved in reviewing and coordinating strategy and testimony for legislative issues related to health and nursing. Works closely with the AaNA Lobbyist. Usually meets on the second Monday of the month. Current Chair is Pat Senner. ❏ Conference Planning Team—Participates help plan the Alaska Statewide Nurses Conference. Roles include working with program planning, marketing, vendor and sponsor recruitment and onsite assistance. ❏ Continuing Education Committee—Members individually review applications for continuing education approval based on the established guidelines of the American Nurses Credentialing Center and in coordination with the CE Director. Makes recommendations for improvements in the application process. The current CE Director is Norma Monsen. ❏ Alaska Nurse Newsletter Editorial Board— Members work with the editor to recruit articles and pictures for the quarterly newsletter. The current editor is Lynn Hartz.

Return to: AaNA, 3701 E. Tudor, Suite 208, Anchorage, AK 99507 or fax (907) 272-0292 or e-mail aknurse@aknurse.org and tell us your selection.

Relationship of Overtime to Consumer Safety and Patient Safety There are several industries in which employees’ working hours are strictly regulated to protect the health and safety of the public as well as the employees who serve them. Unlike many other industries where public safety is a concern, healthcare is exempt from federal regulations that limit the use of overtime. With the exception of eleven states that have passed regulations to address the issue of mandatory overtime, long working hours and the number of hours that nurses may work in providing direct patient care is not regulated in the United States. Other states besides Alaska that are either lining up or have already introduced legislation banning the use of mandatory overtime are Hawaii, Missouri, Pennsylvania, Vermont, Florida, Iowa, New York, Rhode Island, Nevada, Georgia, Michigan, Ohio, Tennessee and Massachusetts.

Dangers of Overtime and Patient Safety Overtime, whether mandatory or voluntary, contributes to poor quality patient care secondary to fatigue and loss of concentration ability. Threats to patient safety that are likely to result from extensive nursing overtime include the following: nurses being less alert to changes in patients’ condition, slower reaction time, medication errors, adverse drug events, errors in clinical judgment, increase in nosocomial infections and an increase in decubiti.

The Institute of Medicine’s report, Keeping Patients Safe: Transforming the Work Environment of Nurses, 2004, stated that long hours worked by some nurses pose some of the most serious threats to patient safety and that prolonged periods of wakefulness can produce effects that are similar to the effects produced by alcohol intoxication.

This may include decreases in reaction time and the speed of mental processes. If you do not want a pilot flying a plane for more than 12 hours, why would you want a nurse to care for you when long working hours have illustrated the likelihood of a medical error? The Journal of American Medical Association in 2002 compared nurses to pilots monitoring their instruments.

Nurses constitute an surveillance system

around

the

clock

and are responsible for detection and prompt intervention when a patient’s condition deteroriates.

Continued on page 10

Page 10â&#x20AC;&#x201D;Alaska Nurseâ&#x20AC;&#x201D;November 2007

Overtime/Long Work Shifts Continued from page 9

Relationship of Overtime to Health Care Costs Any institution that delivers care to Alaskans should be able to recognize the relationship between overtime and increased costs for patients. Health Affairs, 2004 illustrated the most immediate financial impact of the stress and fatigue of long working hours was manifested in absenteeism and turnover in nursing staff, which resulted in low productivity and lost training dollars. Fatigue related absenteeism and turnover invariably leads to higher and preventable hospital operating costs. Every instance of long working hours that results in turnover costs hospitals thousands of dollars in recruitment expenses, hiring and training dollars of new staff.

Nurses working long duty hours experiencing fatigue and slower reaction time have an increased likelihood of a work related injury. Nurses who work longer than 12 hours per day have an increased risk for back, neck, and shoulder disorders. The ANA has estimated that 67% of nurses will incur a work related injury during their career.

Hospitals or institutions that fail to recognize the correlation between long working hours and nursing fatigue increase their medical liability front. An article in Nursing Research, 2005, illustrated that the cost of serious care errors such as hospital acquired infections add an approximately $22,000 to $28,000 in costs per patient when you add up additional care, tests, pharmaceuticals and extended hospital stays.

In 2008, hospitals will embark on the â&#x20AC;&#x153;pay for performanceâ&#x20AC;? guidelines and hospital acquired illnesses and poor patient outcomes will no longer be reimbursable. Failure to improve working conditions for nurses can result in devastating financial losses for medical institutions.

Overtime and Alaskan Public Safety The Alaska public has a right to expect when they walk into a healthcare facility, that the nurse taking care of them is alert and properly rested.

Every patient and family member should ask their bedside nurse how many days have you worked in a row, how many hours have you worked in the last few days or week, how many hours have you worked today, and have you received any breaks or meals today? If the nurse is not forthright with the information that will affect your ability to receive safe and quality care, then ask to speak to a hospital administrator to acquire the information.

SB 28 strictly limiting mandatory overtime is common sense. It will protect the patient.

It will protect the nurse. It will protect the healthcare facility. It will enhance the nursing profession. It will help retain and recruit nurses. SB 28 is good public policy for Alaskans.

Nurses with questions on the legislation or who would like to talk to their legislator to encourage passage of the bill can access the AaNA website for information at www.aknurse.org or contact Legislative Chairperson Pat Senner, ANP, senfam@ acsalaska.net or Kathleen Gettys at bkgettys@gci. net.

RN Safe Staffing Survey The United American Nurses, AFL-CIO (UAN) sponsored the short survey below on RN safe staffing. The UAN is an affiliate of both the American Nurses Association and the AFLCIO. Nurses at several hospitals in Alaska are represented by UAN. As part of the newly launched safe staffing campaign, UAN is collecting feedback from staff

nurses on what staffing levels are like in their facilities. The responses will be shared with the public, elected leaders, the media and you. Please take a minute to complete the short survey below and return it to UAN. This can be done with the hard copy below or on the UAN website, http:// www.uannurse.org/survey/.

What Is RN Staffing Like Where You Work?

A

s part of the newly launched safe staffing campaign, UAN is collecting feedback from staff nurses on what staffing levels are like in their facilities. Weâ&#x20AC;&#x2122;ll share the responses with the public, elected leaders, the media and you. Please take a minute to complete the short survey below and return it to UAN.

How many years have you been an RN? ________________ What is your zip code?________________ Please select the description that best reflects the patient care unit in which you work: ( ) Operating room or trauma emergency ( ) Critical care, intensive care, labor and delivery, post-anesthesia ( ) Emergency, antepartum, pediatrics, step-down and telemetry ( ) Intermediate care nursery, medical/surgical or acute care psychiatric ( ) Rehabilitation ( ) Postpartum and well baby nursery ( ) Other, please specify:

In the unit I work in, the nurse-to-patient ratio the hospital follows most of the time is ____ RN(s) to _____ patients.

When, in my professional judgment, staffing is inadequate for safe patient care: ( ) On my request the hospital provides additional staff. ( ) I can insist that no more patients be accepted in my unit. ( ) I can file an objection to the staffing levels, but must continue to provide care. ( ) About half the time. ( ) I can do nothing but must accept the situation and provide the best care I can under the circumstances.

The direct care institution where I work (please check all that apply): ( ) has established and adheres to safe, appropriate staffing ratios ( ) has established but does not adhere to safe staffing ratios ( ) asserts that staffing ratios are adequate for safe patient care ( ) acknowledges that staffing ratios are sometimes unsatisfactory and does its best to correct the situation ( ) involves direct care RNs and other direct care health care workers in development and annual reevaluation of staffing plans.

The direct care institution where I work adjusts staffing levels based on (please check any/all that apply): ( ) census numbers ( ) the acuity of patients ( ) barriers in the environment (i.e., distance from needed equipment) ( ) the skill level of the nurses I In my unit over the past year patients have actually sustained preventable harm due to unsafe staffing ratios: ( ) never ( ) very rarely ( ) at least once per month ( ) at least once per week ( ) nearly every day Personally, the biggest concern I have about unsafe patient to staff ratios is:

In the unit where I work, safe staffing ratios are exceeded: ( ) Rarely or never ( ) less than half the time ( ) More than half the time. ( ) All or nearly all of the time

Please return this to UAN: 'EORGIA !VE 3UITE 3ILVER 3PRING -$ s Email: UANInfo@UANNurse.org s Fax: 301-628-5347

November 2007—Alaska Nurse—Page 11

Statewide Nurses Conference Opens With Call to Political Action Rose Gonzales, MPS, RN opened the October 21 Statewide Nurses Conference with a call for RNs to find and use their political strength.

Ms. Gonzales is director of government affairs for the American Nurses Association.

“One has to study the old to understand the new.” Chinese Proverb.

Gonzales provided a short history of nursing in this country and noted that in 1896, nurses banded together to seek standardization of educational programs and laws to insure practitioner competency. In September 1896, the Nurses Associated Alumnae of the United States and Canada was formed. It was renamed the American Nurses Association in 1911.

The Association’s political agenda began to take shape. In 1901, the nurses secured passage of a bill to create the Army Nurses Corps. In 1943, the ANA secured a hearing before the U.S. Commissioner of Internal Revenue which resulted in the cost of nurses’ uniforms becoming deductible. The Nurse Training Act was secured in 1964 and in 1965, ANA was the fi rst association to endorse the Medicare program.

Nurses are, have been, and continue to be the most trusted profession in America. They are in a prime position to advocate for improvement in healthcare delivery, she said.

“The power of the nursing profession is dependent upon its ability to maintain the cooperation of individual nurses who have the ability to influence public opinion.” Sophia F. Palmer, February 1895, second annual convention.

“It’s the members! Member involvement and activism is what it takes for an organization to make its needs known before legislative bodies and to push through needed changes at the state and national levels.

“There is No Political Gain in Silence and Submission.” Ms. Sidney Abbot, American author.

Incoming AaNA Executive Director/Program Director Tom Renkes chats with Providence Adult Critical Care nurse Deb O’Brien.

The competition to be heard is formidable. There are thousands of groups vying for the attention of lawmakers and they have formidable Political Action Committee bankrolls. Just on the healthcare front, the amount spent in the 2004-2006 by group totaled: • American Medical Association, $3.6 million; • American Hospital Association, $2.9 million; • American Dental PAC, $1.9 million; • American Association of Nurse Anesthetists, $1.5 million; • National Emergency Medicine PAC, $1.1 million; • American Nurses Association PAC, $767,000; • Osteopathic PAC, $765,000; and • Podiatry PAC, $764,000.

The mission of the American Nurses Association political action program is to elect pro-nurse advocates. Some 89 percent of ANA-PAC endorsed candidates won in 2006.

“We know grassroots political action works,” she said, and gave as an example the passage and signing of the Nurse Reinvestment Act. Gonzales ended her presentation with a call to action and involvement here in Alaska, through donations to the Alaska Nurses political action committee and work for individual endorsed candidates.

Pictured are Michelle Arnold, chair of the Statewide Nurses Conference; Debbie Thompson, president of the Alaska Nurses Association (AaNA); Rose Gonzales, director of government relations, American Nurses Association; and Nancy Davis, Juneau, vice president, AaNA.

The District IV, AaNA, delegation to the Statewide Conference: Cathy Winfree, Fairbanks; Carolyn Adkins, North Pole, AaNA at-large board member; and Suellen Geis, Fairbanks.

Christmas Greetings From the Editor

Son Jason Hartz, daughter-in-law Laura and Alaska Nurse Editor Lynn Hartz wish you the very best Holiday Season.

Page 12—Alaska Nurse—November 2007

2007 Alaska Nurses Association General Assembly Adopts Wide Range of Resolutions Nurse leaders attending the 2007 Alaska Nurses Association General Assembly held at the Captain Cook Hotel, Sunday, October 21, addressed issues ranging from the need for school nurses to disaster preparedness to expanding membership to include other health care workers.

AaNA President Debbie Thompson conducted the meeting. A full range of reports were given on the financial health of the organization and the variety of programs and activities conducted during the past year under the auspices of the statewide nurses’ group.

Resolutions adopted included: 1. Be it resolved that for the coming year a priority for the Alaska Nurses Association will be to educate and mobilize nurses to become prepared for a disaster and work with the Alaska Nurse Alert system to expand their capabilities.

2. Be it resolved that for the coming year the following will be the priorities for the Alaska Nurses Association’s legislative efforts: • Ban on mandatory overtime; • Efforts to make workplaces safer and to support safe patient handling; • Work to ensure the Alaska Nurse Practice Act is not amended in such a way as to negatively impact nursing practice or compromise patient care; • Work to improve Alaska’s disaster preparedness and; • Efforts to expand the number of Alaskans who can obtain health insurance through expansion of Denali KidCare program and supporting new and innovative programs that would make health insurance affordable for most Alaskans.

3. Be it resolved that the Alaska Nurses Association will be involved in efforts to find an innovative way to make health insurance affordable for business and individuals and will support legislation that the Association feels will meet this goal. Such proposals may involve shared financial contributions from individuals, businesses and the government. During all these efforts the Association will work to make sure that nurses are an important player in making decisions about health care and their services are reimbursed by any system that is supported.

4. Be it resolved, that the Alaska Nurses Association supports adequate and safe ratios of nurses to students in all areas of our state.

Be it further resolved, that the Alaska Nurses Association will collaborate with the members of Alaska Board of Nursing to create more clarity regarding delegation in educational and other similar unique nursing practice settings, to help insure safe and lawful school nursing practice.

AaNA President Debbie Thompson presides at Assembly.

AaNA Rural Board Member Dara Whalen, Kotzebue.

Be it further resolved, that the Alaska Nurses Association join the Alaska School Nurses Association in support of creation of a State School Nurse Consultant position.

5. Be it resolved, that the AaNA Labor Program Director shall pursue legal advice regarding changes in the AaNA bylaws necessary for representing non-RN health care workers, and prepare the needed amendments for submission at the Newly elected AaNA atnext general assembly. large board member Michelle 6. The final resolution was presented in Arnold addresses Assembly. support for economic opportunities Sheri Whitehorn is pictured in for women. It read: background.

Whereas, decades of research have shown that when women obtain more resources, they reinvest these resources in their children’s health, nutrition and education; And whereas, expanding economic opportunity for women also decreases men’s vulnerability to trafficking, contracting HIV/AIDS, and experiencing gender based violence and abuse; Therefore, be it resolved that the Alaska Nurses Association supports initiatives and/or legislative efforts, such as the GROWTH Act, that promote and support development of economic opportunities for women worldwide.

November 2007—Alaska Nurse—Page 13

Nurses in the News Karen Decker-Brown, ANP opened Humanistic Healthcare LLc at Huffman Business Park in Anchorage last November. Ms. Decker-Brown owns a solo practice and will provide family health care. She is a preferred provider with most insurance companies.

Resources Expand your horizons Want to take your career to the next level or simply need a new job? Ever wondered what a change of scenery would be like? ANA Nurse’s Career Center, created specifically for nurses, can help you explore the world of opportunity. New nursing opportunities across the country are posted each day. Visit www.nursescareercenter. com today and see what’s out there!

American Nurses Association Releases Revised Scope and Standards for Nurses in Hospice and Palliative Care 07/27/07 Hospice and Palliative Nursing: Scope and Standards of Practice, the latest addition to ANA’s library of nursing specialty publications, reflects the immense changes in hospice and palliative care since the last edition in 2002. Again, copublished with the Hospice and Palliative Nurses Association, the book details nursing’s leading edge in a critical healthcare arena. For more information see nursingworld.org.

Survey: Government responsible for adequate health coverage a majority of U.S. adults feel “it is the government’s duty to ensure that all Americans have adequate health-care coverage,” according to a Wall Street Journal Online/Harris Interactive poll conducted last week. Poll results also showed that people trust Democrats more than Republicans when it comes to formulating policies on health care reform. The Wall Street Journal (subscription required) (9/19) Lung cancer guidelines released screening not advised The American College of Chest Physicians released 260 recommendations for the prevention, diagnosis and treatment of lung cancer. The report says screening for lung cancer with CT imaging or sputum tests does not reduce the number of deaths and could put patients at risk for other complications. Yahoo!/Reuters (9/12) New RN to MSN (Bridge Program) Online The Regis University (AACN-CCNE) accredited RN to MS in Nursing via The College Network allows busy nurses to take the fast track to earning their MSN with No Waiting List! Earn both BSN/MSN degrees in less time at 1/2 the cost of traditional programs. Local clinicals and No Clinical Testing. Visit: www.college-net.com/ nursing/ANANL071015.

Revised CPR guidelines emphasize chest compressions Health experts have revised CPR guidelines and now recommend a ratio of two breaths per every 30-chest compressions. Experts say the simpler guidelines and faster, easier CPR training will help save more lives. Yahoo!/HealthDay News (10/15) ACNP is pleased to announce the launch of its CE Online Learning Center!

This site offers CE credits for NPs in a convenient, easy to access environment. The initial CE sessions were presented live at the 2006 National Clinical Conference. Watch for new and exciting continuing education sessions from the upcoming 2007 Clinical Conference in San Antonio!

Detailed information for obtaining CE is found on the site, accompanied by FAQs. Support is available if necessary. Your suggestions are welcome for additional CE content

Upcoming Events 2008 NDNQI® National Data Use Conference The American Nurses Association (ANA) is hosting the 2nd annual National Database of Nursing Quality Indicators® (NDNQI) National Data Use Conference on January 30-February 1, 2008, in Orlando, Florida at the Royal Pacific Resort at Universal Orlando®, A Loews Hotel.

The theme for this year’s conference is Workforce Engagement in Using Data to Improve Outcomes.

For more information visit http://ana.confex. com/ana/ndnqi08/cfp.cgi 2008 National Nurse Practitioner Summit and Leadership Conference February 7-10 Washington, DC

2008 Advanced Public Policy Institute March 10-14 Washington, DC ACNP is pleased to announce the launch of its CE Online Learning Center!

This site offers CE credits for NPs in a convenient, easy to access environment. The initial CE sessions were presented live at the 2006 National Clinical Conference. Watch for new and exciting continuing education sessions from the upcoming 2007 Clinical Conference in San Antonio!

Detailed information for obtaining CE is found on the site, accompanied by FAQs. Support is available if necessary. Your suggestions are welcome for additional CE content. To view a complete list of current CE offerings, check the ACNP website.

Review classes every Wednesday beginning January 16, 2008-April 16, 2008 from 3:45-7:00p.m. in Conference Room 2 at ANMC 42 credit hours Course provided in Conjunction with University of Washington School of Nursing Great review for med./surg.

Certification exam

Application Forms Available Contact Cindy Lietzau at 729-1134 or E-mail clietzau@anmc.org Tuition $645.00 ANMC employees fill out employee education request form and obtain manager approval.

Page 14—Alaska Nurse—November 2007

Letters to the Editor If you are interested in writing a letter to the Alaska Nurse, we are interested in printing it! Do you have comments, opinions or questions about nursing and health care in Alaska? Send your letter as an email to editor@aknurse.org. Letters should be limited to 500 words or less. They may be edited for length, clarity and grammar. Remember, the AK Nurse is published every three months so be careful about sending time sensitive material. Be sure to include your name and contact information.

Pictured from left to right are Pat Senner, ANP, Legislative Chairperson for AaNA, Senator Hollis French and Laura Sarcone, Certified Nurse Midwife.

Alaska’s Nurses Understand the Plight of the Uninsured Better Than Most They know that primary care in the emergency room, where ‘free’ care is available for those who cannot pay, is less than ideal. Nurses know that quality preventative medicine produces the best health outcomes, because an ailment that never occurs beats a good cure any day. When uninsured patients enter the emergency room, nurses are sometimes confronted with problems that could have easily been avoided with proper primary care.

And when that essential primary care hasn’t been sought due to the cost of care, everyone—including patients, nurses, doctors, insurers, and people who pay for coverage—ends up worse off. This problem doesn’t only affect Alaska’s nurses, though they are on the front lines—it affects all of Alaska.

Other states have taken bold steps to address the issue, and in that spirit I have been working on Senate Bill 160, which would make health insurance affordable for all Alaskans. Like Massachusetts’ recently implemented reform effort, this bill is comprehensive; it requires that every Alaskan acquire basic health coverage. In addition to reducing costs, universal coverage in Alaska would reduce the financial burdens created by uncompensated care—burdens that are currently placed on providers and those who pay for services. While the individual mandate requires that each Alaskan acquire health coverage, the responsibility to make coverage affordable falls on the state. To this end, SB 160 would provide vouchers to individuals and families that cannot afford coverage on their own. The solution can’t be an unaffordable mandate… all stakeholders should contribute to the health and well-being of Alaskans.

While the road to reform will not be short, the process has gotten off to a great start in Alaska. On September 10th a joint meeting of the Senate Labor and Commerce and Senate Health, Education and Social Services committees considered the bill in Anchorage. In total, 12 legislators listened to the three hours of testimony, which included statements from 10 local stakeholders.

Pat Senner [RN, ANP and Legislative Chairperson, ed.] shared comments from the perspective of the Alaska Nurses Association. Two national experts traveled to Alaska to weigh in on the bill, one from the Heritage Foundation and another from the Cato Institute. Everyone left with a greater appreciation for the problem and a desire to work towards a solution, however it may be constructed.

The health care reform debate has begun in Alaska, but it needs help from people like you. I encourage you to visit SB 160’s website, www. healthyalaskans.com, to learn more about the details in the bill. The site includes written documents explaining SB 160 and an interactive calculator that shows the viewer how they would fit under the plan. If you have comments or suggestions, please let my office know—we can be reached through the website or at (907) 269-0153. I look forward to working with each of you as we press for meaningful health care access changes in Alaska.

-Hollis French Alaska State Senator District M, Anchorage