The Alaska Nurse - Vol. 59 No. 2 - May 2009

The Official Publication of the Alaska Nurses Association Circulation 7,700 to every Registered Nurse, Licensed Practical Nurse and Student Nurse in Alaska

Volume 59 • No. 2

May 2009

Page 3

Limiting Mandatory Overtime for RNs in the 26th Session

by Joshua Meals and Lynn Hartz As the Alaska State Legislature finished the first half of it’s 26th session, SB12 and HB 50 ended up in the Senate and House Finance Committees. With the aid of sponsors Senator Bettye Davis, Representative Peggy Wilson, RN and a large group of bi-partisan co-sponsors, the limit mandatory overtime bill/patient safety act continues to push forward in the halls of the legislature.

The purpose of the bill is to promote patient safety and better working conditions for nurses.

“Nurses are working excessive amount of hours without adequate rest. This creates an unsafe environment for patients and nurses,” according

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to Representative Wilson’s sponsor statement.

Senator Davis states, “SB 12 prevents registered nurses and licensed practical nurses from being forced to work mandatory overtime, i.e., work beyond an agreed to, predetermined, regularly scheduled shift, and it protects patients from the dangers caused by overworked nurses.”

This is truly a safety issue, and nothing more.

By eliminating mandatory overtime, registered nurses can rest assured that the only overtime worked will be made based on professional judgment. Each year we continue to move closer to the passing of this important legislation, and in past years we have met with many obstacles.

This is why it is important that your senators and Limiting Mandatory Overtime continued on page 5

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University of Alaska Nursing Graduates

Page 12

Bringing More Eyes to Critical Care

by Julie Torres, RN, CCRN and Cecilee Ruesch, RN, CCRN Providence Alaska Medical Center began its eICU program on Jan. 22, 2009. The eICU program combines early warning alerts and remote monitoring technology to connect off-site critical care specialists to ICU patients and their care teams within Providence’s Adult Critical Care Unit (ACC). Providence plans to offer the program to outlying hospitals, supplementing local care.

The Providence eICU serves as a second set of eyes for remote monitoring of patient vital signs, medications, blood test results, X-rays, and other data for the 28 beds in Providence’s ACC. Using advanced computer algorithms, the eICU continuously analyzes patient conditions and alerts medical staff to potential problems before they occur.

Currently the eICU is using a nursing model staffed 24/7 with experienced critical care nurses, who have an average of 15 years

experience. The majority of the nurses are either CCRN certified or in the process of obtaining certification. Intensivist physicians will join the program in September of 2009.

The eICU has brought a new level of support and mentorship to the critical care team of nurses at Providence. Michele Podems, an eICU/ACC nurse stated that “the eICU brings an even greater sense of patient care and safety to our patients.”

Last fall, members of a multidisciplinary team met to develop workflows for the new program.

A mentoring workflow was developed to support new critical care nurses in their transition to life and work in the busy ACC unit. Workflows for communication with LifeCenter Northwest (organ donation) and Poison Control were also developed in an effort to allow nurses more time at the patient bedside.

Amber Jolin, RN, stated, “Having the eICU RN available to help with admission paperwork and medication reconciliation has made it possible for me to be at the bedside providing direct patient care.”

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Michele Podems, RN sitting and Cecilee Ruesch , RN, (nurse manager) standing in eICU. Photos taken by Kirsten Schultz-Brogan, on Activation day January 22, 2009.

Bringing More Eyes to Critical Care continued on page 6

Inside This Issue President’s Message . . . . . . . . . . . . . . . . . . . . . . . .

Essay—Blurry Boundaries . . . . . . . . . . . . . . . . . .

Advanced Practice Registered Nurse Model for Regulation . . . . . . . . . . . . . . . . . . . .

Commentary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Nurses in the News . . . . . . . . . . . . . . . . . . . . . . . .

Lifelong Alaskan/Neurological ANP Joins New Practice . . . . . . . . . . . . . . . . . . . . . .

2 3 4 5 6 6

Local Nurse Provides Care Around the World . . . . . . . . . . . . . . . . . . . . . . 7 Environmental Health . . . . . . . . . . . . . . . . . . . . . . 8 Membership Application . . . . . . . . . . . . . . . . . . 10 AaNA Legislative Report. . . . . . . . . . . . . . . . . . . 11 The University of Alaska Nursing Graduates . . 12 Resources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 Upcoming Events . . . . . . . . . . . . . . . . . . . . . . . . . 14 Letter to the Editor . . . . . . . . . . . . . . . . . . . . . . . . 15

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

Page 2 • Alaska Nurse

May 2009

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. Photos should be provided with a caption and photo credit info and be high resolution. 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.

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: Nancy C. Davis, MSN, RN Vice President: Open Secretary: Diana Robinson, RN Treasurer: Donna Phillips, BSN, RN

President’s Message This is my first opportunity as the President of AaNA to greet you, having moved from being Vice President to President in January with Debbie Thompson’s appointment as our new Executive Director. While I watched with amazement at the pace of the 90-day Legislative session, I am also struck by the pace of our own Alaska Nurses Nancy Davis Association.

RN, MSN Since January, we have Juneau, Alaska been engaged in organizing efforts, preparing for important negotiations on bargaining agreements, learning new roles and responsibilities, changing our dues processing for some of our members, planning the Statewide Nurses Conference for the Fall of 2009, advocating for legislation important to nurses, patients, and to the health of Alaskans, moving the Nurse Alert system forward, and keeping up with events and happenings on the national nursing front.

Our world as nurses is full of challenges and opportunities.

Those who know me well will say that anytime I start talking about “challenges and opportunities” there is bound to be a lot of work ahead. And that is certainly true for AaNA and nurses in Alaska. Nurses, recognized in Gallup polling for the seventh year in a row as the most trusted professionals, are being looked to for ideas and answers about how to improve the health system.

Nurses have been appointed to several highranking positions in the Obama administration,

and the American Nurses Association has been invited to White House discussions on Health Reform. There is a nationwide alliance between AARP, the Robert Wood Johnson Foundation and Nursing organizations to transform and improve nursing education to meet the future demands of nursing. There is a lot of work ahead.

Alaska and America needs nurses talking out loud about the value of nursing in health care and how critical nurses are to the health of patients and communities. While we all have our complaints on any given day, let’s resist the urge to say first and only what is wrong: rather, let us proudly say to others and ourselves, what an extraordinary opportunity we have as nurses to make a difference in people’s lives. Those are powerful words!

We are active partners in health outcomes and the well being of patients and families. We need each and every nurse actively involved in decisions in the workplace that ensure the best outcomes for patients. Nurses can be leaders wherever they are. They can be strong and vital voices for social justice, equity, and safety for patients, families, communities, and for all nurses and health care workers. We can nurture and guide nurses new to the profession, we can encourage students to choose nursing, and we can encourage each other to excel and thrive in our nursing careers. We each can lead in some way, in our workplace, in our community or neighborhood, in education, in service, and in our organization.

The challenges are numerous, and the opportunities are endless for nurses. Beverly Malone, an honored past President of ANA, said we need more than change, we need transformation. She said “Change is when I give you a dollar and you give me back four quarters.

Transformation is when I give you a dollar and you give me back five dollars.” Nurses can lead to the transformation of health care in America and in Alaska. I look forward to working with Alaska’s nurses, the most incredible force for health in our state, toward our healthy future. I will do my best to represent all nurses, and to be a respected voice for nursing. With your support, your input, and your commitment to excellence in nursing, AaNA and Alaska Nurses, like the North Star, will shine brightly, and lead the way.

Directors: Labor Council (designee): Susan Walsh, RN Greater Alaska Director: Shelley Burlison, RN Staff Nurse Director: Kathleen A. Gettys, BSN, BA, RN Rural Director: Jennifer Straight, RN Director at Large: Carolyn S. Adkins, MS, RN Paul T. Mordini, RN Shirley LaForge, RN Joe Peacott, RN Pat Senner, MS, RN, ANP AaNA Labor Council Chair—Donna Phillips, BSN, RN Vice-Chair—Mary Stackhouse, RN Secretary—Karen Friedl, MSN, RN Treasurer—Megan Orien, RN Directors—Joshua Meals, BSN, RN Directors—Kathleen Gettys, BSN, BA, RN PAMC BU Rep.—Cindy Price, RN Soldotna BU Rep.—Velinda Albrechta-East, RN Ketchikan BU Rep.—Susan Walsh, RN UAN Delegate—Joshua Meals, BSN, RN Affiliate Organizations: Alaska Chapter of the American College of Nurse Midwives Alaska Home Health and Hospice Association Alaska Nurse Anesthetists Association Alaska Nurse Practitioner Association Alaska School Nurses Association Forensic Nurses Association, Alaska Chapter Executive Director: Debbie Thompson, BSN, RN, CNOR Advertising Rates Contact—Arthur L. Davis Publishing Agency, Inc., 517 Washington St., P.O. Box 216, Cedar Falls, IA 50613, 800-626-4081, sales@aldpub.com. 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.

Alaska Nurse on the Web You can now view the Alaska Nurse on the web at aknurse.org. Just click on the picture of the newspaper for the .pdf version. A benefit of the .pdf version is that you can click on hot links and web sites in that version and go straight to the site.

Archives of the Alaska Nurse can also now be found at aknurse.org.

Click on Alaska Nurse Archives.

May 2009

Alaska Nurse • Page 3

Photo taken while flying over the Aleutians.

by Rosemary Graffius, FNP “You’ve got to come now! I can’t get a pulse…I can’t do this! Please, please Rosemary come now!”

The voice screamed through my phone after midnight. My heart pounded as I tried to piece together information from the distraught health aide in a small village. A roll over car accident has taken the life of her 20 year old niece, who was also her coworker. Two other cousins were alive and needing treatment. Gulping breath swallowed grief…and she was able to provide care for the relatives that still needed her. I started making phone calls from Cold Bay, a forty-five minute

flight away. Local planes were grounded due to bad weather; the Coast Guard crew was five hours away. In spite of everyone’s best efforts to help, this incredible health aide had to continue on her own for several hours before I could get there at daybreak. Melinda was just beginning her role as a Health Aide as I was beginning mine as a nurse practitioner in this remote part of the Aleutians. I spoke with her almost daily to consult on patients, visited her community every few weeks and over time, became a mentor and friend. We had worked together in many difficult situations, but this one stretched us both. As dawn approached, I still couldn’t get to her. Tears of frustration and

sadness fell as I kept trying. Work relationships often become so much more in these villages. We depend on each other and in the process become almost like family. When I was finally able to hold her and she was able at last to let her grief spill out, I felt more like I was holding my daughter than a coworker.

This is the daily reality of providing health care in remote Alaska. We are often alone to care for our community, friends and family members.

Sometimes there may be an EMT or community member who knows first aid. Phone contact with a hospital hundreds of miles away or maybe a colleague a bit closer is the best we can hope for in emergencies. Drowning, fire, severe trauma, sick babies, domestic violence, suicide, rape, stabbings, gun shots…every event that happens in big cities, happens in these remote villages; the only difference is that most of the time you are alone with a phone.

Imagine listening to your mother’s labored breaths as she struggles for air during the hours waiting for a medivac plane. Oxygen is all you have to help relieve her distress. Listen to the quiet sobs in the corner of the room when you are doing CPR on a five month old baby who is the grandchild of your coworker. The suicide victim is the teenage son of your best friend. You receive a radio call about a four-wheeler accident in the area where you know your son is riding and you won’t know until the victim arrives in the ER whether or not it is your own child. The baby you deliver on a foggy night when the planes are delayed is the grandbaby of two co-workers. One health aide even had to talk her EMT through the treatment for anaphylaxis for herself.

One morning, I was flying from a village with a 20 year old man who was in danger of losing his arm from a serious bar fight the night before. A few hours earlier, he had been combative and out of control, now he seemed more like a son, scared and in need of some motherly reassurance. As we flew over the mountains, the grays and pinks of predawn fog swirled together in a watercolor Essay—Blurry Boundaries continued on page 4

Page 4 • Alaska Nurse Essay—Blurry Boundaries continued from page 3 wash, making it difficult to see where the mountains ended and sky began. There were no clear boundaries as the colors and shapes merged.

Nothing in our professional education prepares us for these “blurry boundaries.” In the “normal” world, we are encouraged to have clear boundaries between work relationships, patients and friends.

It is not “professional” to mix personal life with our patients but in bush Alaska, this standard isn’t possible.

My 16 year old son flicked on my bedroom light and announced, “I broke my arm, Mom.” “Don’t fool around Joe, I’m too tired,” I snapped.

I had been up for 36 hours with medivac patients and was not in the mood for his habit of joking around. “No, I really did break my arm,” and he pulled back his jacket to reveal a definitely crooked wrist. My fatigue vanished as I jumped up to care for my injured child. We got to the clinic for the confirming x-rays and splinting process.

Unfortunately, my son has a lot more experience with casts than I have. I was struggling with fiberglass casting material that apparently was too old. My son became irritated with the process and started to protest loudly. I was too tired and too stressed to cope very well at this point. “Forget it, do it yourself!” and gave in to tears of frustration.

After a couple of deep breaths and a hug, I suggested, “Let’s just start over and pretend we aren’t related!” My dear son went out of the clinic, and came back in. “Hi Mrs. G…I think I broke my arm.” “Oh, I’m sorry Joe! Let me help you,” I responded and we continued with much greater success than our previous encounter. We were both having fun with our role play and the stress dissolved with humor. Humor and respect are key elements when trying to help friends and relatives.

It is difficult to be objective when we are intimately involved with our patients. Did I miss the class that taught us how to do this? In bush

May 2009 Alaska, we don’t have the luxury of this kind of objectivity. Health care providers are daughters, wives, husbands, sons, mothers, fathers, friends, aunts, uncles, grandmothers, grand daughters, brothers, sisters…we live here and there is no separation between work and home.

I’ve never completely bought into the medical model of separation though. After more than 30 years of being a nurse, I am finally able to admit that I have spent most of my life breaking these “rules” of “medical professionalism.” I used to sit on the bed of a dying patient, holding her hand knowing that if caught, my instructor would remind me about germs on my uniform. I’d probably have to have a locker of clean uniforms if I worked in a hospital today! I’ve had cups of tea with lonely elders, and brought a meal to an overwhelmed new mom. I taught a mom who had been a victim of parental abuse, how to make Christmas cookies with her kids. I’ve given baths, picked up groceries, done the dishes, and taken walks. Sometimes we might cry or pray together when I have to give them bad news, and I often wake up in the night to pray for them again.

Many of my patients do become my friends at least for a while. Isn’t that what nursing is about, understanding where someone is in their journey of healing and meeting them there? Healing most often begins on the inside. When patients feel valued and listened to, they can reach inside for the insight and strength to begin the healing process. My job, as I see it, is as a companion and occasional guide on the journey. In truth, I’m usually the learner.

I used to feel a bit guilty for smudging the sharp

edges of “professionalism,” but years of experience have shown me that being real with my patients has been a catalyst for their healing. Intuitive nursing is not something I was taught in school, or something that can be proved by “evidence-based medicine”...but something I know in my heart to be true.

Living and working in remote Alaskan communities as a health care provider may be easier for someone who has practice with “blurry boundaries.” People may want to talk about their lab work in the grocery store or you may be awakened in the middle of the night by a frantic call. You may need to care for a loved one when you’re exhausted and scared. Sometimes a community or individual can be angry and blame you for a poor result that had nothing to do with your care. How do we still have healthy boundaries, even if the edges are a bit blurred?

We can find ways to encourage each other in the process. We can share our stories and acknowledge the special challenges we face here. We have to be our own teachers. Maybe our way could be a model of real healing for the rest of the medical world. We are sharing our humanness. In our “real” world, boundaries might be blurred, but we somehow find a thread of energy in the middle of the night and face it together. Real people with real joy, sorrow and hope-transparent by necessity, brushstrokes of this incredible water color canvas called life.

[Ms. Graffius RN-C, FNP lived in Cold Bay, Alaska in 2000. She now works for Southcentral Foundation as a Nurse Practitioner in McGrath, Alaska.]

Advanced Practice Registered Nurse Model for Regulation

by Catherine Giessel, MS, RN, ANP, FAANP An important topic Presentations on the new Model for Advanced Practice Registered Nurse Regulation have been given to an Alaska Nurse Practitioner Association meeting and to a few FNP students at UAA This is an important topic for Alaska Advanced Nurse Practitioners.

So, to increase distribution of the information, I am presenting a Ms. Giessel very brief summary of the topic. is the current But first, consider these Chairperson of questions: the Alaska Board 1. If an Alaska nurse of Nursing. practitioner or nurse midwife were moving to Colorado, what would the ANP have to do in order to practice there, with prescriptive authority?

2. What if a licensed NP in Oregon wanted to move to Alaska and get an ANP license here - what factors would affect that?

3. If a clinical nurse specialist was moving to Alaska from Idaho, what would be required to be licensed in Alaska?

4. What would be different for a nurse practitioner from Alaska moving to practice as a nurse practitioner or nurse midwife in South Dakota?

As you examine the answers (which can be found at the end of this article), you will see, graphically illustrated, the impetus that created the Consensus Paper for APRN Regulation and the APRN Model Act/Rules and Regulations.

Why create a Model?

There is fairly good continuity for Licensed Practical Nurse and Registered Nurse practice across the states. But Advanced Practice Registered Nurses (APRN) encounter differing scope of practice authority, as they move from state to state.

States have different prescribing authority.

Some require national board certification and some don’t. There were about 6 different titles used to designate advanced practice nurses across the states. The advanced scopes of practice vary widely. Some states recognized clinical nurse specialists as advanced practice and some do not.

These are just a few of the variations from state to state.

Two documents, the Consensus Model for APRN Regulation and the APRN Model Act, are

important in that they will shape APRN practice in the future. Both of the papers are available on the public side of the National Council of State Boards of Nursing website at https://www.

NCSBNn.org/170.htm.

Common elements recommended The Model Act/Rules seeks to establish the highest level of scope of practice for APRNs. It describes the independent practice of APRNs as primary care providers in all states, with no requirements for collaboration, direction or supervision. This includes assessment, diagnosis and management of patients, with the use and prescription of both pharmacologic and nonpharmacologic interventions. The prescriptive authority is an independent function, without supervision, delegation, direction, or a formulary limitation.

The Model defines the APRN as educated, certified and licensed in one of four roles: Nurse Practitioner, Certified Nurse Midwife, Certified Registered Nurse Anesthetist or Clinical Nurse Specialist. Each role would have a population focus that is broad.

There are 6 population foci: family (individual across the lifespan); adult/gerontology; women’s health, gender-related; pediatrics; neonatal; psychiatric/mental health. The APRN would be prepared with the acute care and primary care competencies in at least one of these populations.

Specialization could occur beyond the populationfocused education but would be under the jurisdiction of the professional and the choice of the individual APRN. The title, “Advanced Practice Registered Nurse” (APRN), is recommended to be the licensing title used by all states. The title and role designation would be legally protected and may not be used by individuals who do not hold proper credentials.

The Model supports the use of the title “Doctor” for doctorally prepared APRNs. The Model advocates for an APRN Compact that would allow inter-state practice in all participating states. The Model recommends use of an APRN advisory committee by the Board of Nursing, with representatives from all four APRN roles.

“Direct patient care to individuals” is a key element in the definition of the APRN. There are many graduate-educated nurses who do not provide direct care to individuals. These nursing degrees may be in administration, education, informatics and public health. Despite their Advanced Practice Registered Nurse continued on page 5

May 2009 Advanced Practice Registered Nurse continued from page 4 graduate education and vital role in healthcare, these nurses do not require regulatory recognition beyond a Registered Nurse license by their states.

They would not be considered fulfilling the definition of Advanced Practice Registered Nurse.

APRN specialties would represent a focused practice beyond the basic role and population focus. The specialties would not be regulated for licensure; they would be developed and offered by the professional organizations. Some examples of these would be: oncology, orthopedics, nephrology, palliative care, critical care, diabetic management, etc. Specialty preparations will not replace educational preparation in the role or one of the 6 population foci, nor could it expand one’s scope of practice beyond the licensed role and population focus. In other words, a psych/mental health NP could not expand their scope into diabetic management.

Summary This is a very brief overview of the Consensus Model for APRN Regulation and the Model Act/ Rules and Regulations. These are documents every Advanced Practice Registered Nurse will want to review for themselves. Both of the papers are available on the public side of the NCSBN website at https://www.NCSBNn.org/170.htm.

These two papers are models, not mandates.

They contain significantly important aspects that promote APRNs as independent, autonomous primary care providers, with full prescriptive authority. There are many states that are a long way from this ideal. It is up to each state Board of Nursing to determine what aspects of the Model they could implement.

Answers to the questions at the beginning: 1. Colorado uses the title Advanced Practice Nurse (APN). If moving to Colorado, having had a license in good standing in Alaska, the APN could apply for prescribing authority by submitting a letter from a physician. The letter would need to attest to the fact that the APN had 1800 hours of appropriately prescribing during the last 5 years in Alaska.

2. Oregon uses the title Nurse Practitioner (NP).

Oregon does not require national certification for NPs. Therefore, the Oregon NP wanting to be licensed in Alaska, would need to become nationally certified by taking the appropriate certifying examination. It can take several months to apply, be accepted and complete the certifying examination.

3. Idaho uses the title Advanced Practice Professional Nurse (APPN). The Clinical Nurse Specialist would not be able to be licensed as an advanced practice nurse in Alaska. Alaska would license them only as a Registered Nurse.

4. South Dakota uses the titles Certified Nurse Practitioners (CNP) and Certified Nurse Midwifes (CNM). The South Dakota Board of Medicine and Board of Nursing together regulate CNPs and CNMs. In South Dakota, CNP and CNM practice, including prescribing, would require direct supervision by a physician.

Additional references Chornick, N, APRN Licensure versus APRN Certification: What is the Difference?, JONA Healthcare Law, Ethics and Regulation, 10(4), October-December 2008, pgs 90-93.

Stanley, J, Reaching Consensus on a Regulatory Model: What does this mean for APRNs?, Journal for Nurse Practitioners, February 2009, pgs 99-104.

Alaska Board of Nursing Information The Alaska Board of Nursing has a listserve that is used to send out the latest information about upcoming meetings, agenda items, regulations being considered, and other topics of interest to nurses, employers and the public.

To sign up for this free service, go to www. nursing.alaska.gov Choose the “Subscribe Now” box, just above Board Staff information.

Alaska Nurse • Page 5

Commentary

by Martha Herriott PhD, ANP The Alaska Board of Nursing is at the beginning stage of discussing application of the Advanced Practice Registered Nurse Model Act/Rules in Alaska. On the national level, the Alaska Nurse Practitioners Association was represented in these deliberations by our two national affiliates, the AANC and ACNP. We applaud this national level collaborative effort, and believe its principles Ms. Herriott is will benefit both health care President of the Alaska Nurse consumers and Advanced Practitioner Practice nursing.

Association.

Advanced Practice Registered Nurse (APRN) is the new title recommended for what we call in Alaska ANPs, or Advanced Nurse Practitioners. As Ms. Giessel’s article notes, the Model defines APRN and includes within that definition Nurse Practitioner, Certified Nurse Midwife, Certified Registered Nurse Anesthetist and Clinical Nurse Specialist.

An important component of the Model act is the recommendation that state boards of nursing Limiting Mandatory Overtime continued from page 1 representatives hear from their constituents…this is how it works, and this is what it will take for the bill to pass. Please take time and call or write your representative and senator to tell them how important this bill is to you and the patients you care for. You can contact your legislator between sessions (they might have more time to pay attention!) and of course as the new session starts next January. If you have any questions please feel free to call the Alaska Nurses Association at 274-0827. If you have any stories about mandatory overtime, including being “on-call”, and would like to share your story…please call Joshua Meals, RN, BSN at 748-1735, or the AaNA. Thanks for your help and involvement. And if you are in the following legislators district, please thank them for their support of this legislation:

establish a Nurse Practitioner advisory committee.

Such a committee serves as a resource to a state nursing board regarding APRN issues.

The Alaska Nurse Practitioner Association believes that this is the time to establish such an NP Advisory committee. Changes recommended in the new Model could have a significant impact on NP’s in Alaska if adopted by our Board of Nursing. Because of our unique patient populations and health care delivery systems, it is important that implementation of the new Model be based on in-depth understanding of the uniqueness of NP practice in our state. An NP advisory committee, representing both rural urban practitioners, and including all NP specialties, would be an invaluable resource to the BON as it deliberated about the Model.

The APRN Model for Regulation and consensus statement were developed through a process that stressed collaboration, collegial respect, and transparency. We owe it to our state that the implementation of this fine document is done in a similar spirit. We believe the timely establishment of the NP Advisory Committee is an essential first step.

[Dr Herriott provides psychotherapy and medication management in her private practice near downtown Anchorage. She is licensed in Alaska and Washington, and is a past member of the Washington State board of nursing.]

Sponsor Senate Bill 12: Senator Bettye Davis Sponsor House Bill 50: Rep. Peggy Wilson Also signing on as sponsor to HB 50: Rep. Gara, Tuck, Petersen, Lynn, Seaton, Gatto, Cissna, Munoz, Gardner.

Signing on as co-sponsors of HB 50: Rep. Ramras, Foster, Kertulla If you’re not familiar with House Bill 50 or Senate Bill 12, check out: http:// w w w. l e g i s . s t a t e . a k .u s / b a s i s /g e t _ b i l l _ t e x t . asp?hsid=HB0050A&session=26 (HB 50) http:// w w w. l e g i s . s t a t e . a k .u s / b a s i s /g e t _ b i l l _ t e x t . asp?hsid=SB0012A&session=26 (SB 12) Unsure who your legislators are? Check out: http://w3.legis.state.ak.us/misc/districts.php [Joshua Meals, RN, BSN, is a member of the AaNA labor council.]

Page 6 • Alaska Nurse

May 2009

Nurses in the News Providence Alaska Medical Center nurses Christie Artuso, Heidi Wedekind and Margo Yanagawa have earned Certified Neuroscience Registered Nurse credentials through the American Board of Neuroscience Nursing.

Arturo is the director of neuroscience services.

Wedekind is the clinical manager of the inpatient neurology unit and Yanagawa is a staff RN on that unit.

The three are the only CNRNs in the state of Alaska. Neuroscience nursing practice includes clinical practice, consultation, research and administration or education in the neurosciences field, which addresses nervous system functions.

[Anchorage Daily News 3/2/09]

American Academy of Nurse Practitioners board member Deb Kiley, FNP represented AANP at a national , roundtable discussion on chronic pain.

Leading pain specialists and representatives from key clinical and patient advocacy organizations convened November of 2008 to address growing misuse and abuse of pain medications and to call for recognizing chronic pain as a chronic disease.

The news brief can be accessed via the publication The Clinical Advisor titled “Coalition of Pain Experts Offers Guidance on Measures to Prevent Misuse and Abuse of Pain Medications.” [AANP News Brief, 3/4/09]

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Dianne Tarrant, FNP of Anchorage has been elected by the American Academy of Nurse Practitioners as the Alaska State Representative.

Her term of office is two years. Ms. Tarrant owns the Ravenwood clinic in Anchorage as well as being a UAA Associate Professor in the Graduate Nursing Department.

Tarrant also serves as cocoordinator of the Family Nurse Practitioner tract at UAA. AANP was founded in 1985 and is the oldest, largest and only full-service national professional organization for nurse practitioners of all specialties with more than 26,500 individual members and 145 group members.

Thomas J. Hendrix, PhD, RN, Assistant Professor in Health Policy & Administration at the School of Nursing, University of Alaska, Anchorage, was appointed by Governor Palin to the Alaska State Board of Nursing and confirmed by the legislature in April 2009.

Bringing More Eyes to Critical Care continued from page 1 The purpose of this program is to improve patient outcomes. As this program grows it will allow for better support of the critical patient here in Alaska. Having critical care physicians and nurses available in remote areas via this technology will improve the lives of Alaskans.

“Implementation of the eICU program is one more example of our continuous pursuit of clinical excellence,” remarked Dr. Roy Davis, chief medical officer for Providence Alaska Medical Center. “Justice is a core value—equal access for all patients. ‘Getting the right patient the right treatment at the right time’ is the mantra for critical care. This program allows us to deliver that level of care right where they are—a significant benefit to the communities in Alaska.”

For more information on the eICU Program at Providence please contact eICU clinical manager Cecilee Ruesch at cecilee.ruesch@providence.org.

References: /PRNewswire/ March 4, 2009 VISICU and Providence Alaska Medical Center Press Release

■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■

Hendrix

Nancy Zellmer, ANP, Geriatric Nurse Practitioner has joined the practice of Drs. Brownsberger and Hurlburt. Zellmer specializes in geriatrics and Internal Medicine and is taking new patients at 3340 Providence Drive, Suite 358, Anchorage, AK. Phone 907-212-2880.

■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■

Donna Phillips, RN, BSN, Governor Sarah Palin, and Joshua Meals, RN, BSN in the halls of Juneau’s Capital. Governor Palin met with members from the AaNA January 27th and 28th when they visited Juneau for the annual AFL-CIO state convention.

Lifelong Alaskan/Neurological ANP Joins New Practice As a kid growing up on her parent’s Anchorage homestead in what is now the sprawling neighborhood of Fairview, Mo Hillstrand could not have known the tremendous growth that would sweep across the state and the impact it would have on the medical community and her own life. Now, as an ANP in Alaska Neurology Center, Hillstrand sees how Mo Hillstrand, the remarkable advances of ANP the past two decades have improved the level of care patients can get in Alaska, and she has become a leader in the Alaska nursing community.

Hillstrand began her nursing career after earning her Bachelor of Science in Nursing at UAA in 1979.

She spent three years working at the Alaska Native Medical Center’s emergency department learning first hand about the tremendous range of need among patients. After earning her Master’s in Nursing, Business Administration and Advanced Nursing Practitioner (ANP) credentials in 1989, Hillstrand stayed active in academia, teaching in the ANP program at UAA in the early 1990’s. She has also served as President of the Alaska Nurse Practitioner Association and headed its’ Directory Project for a number of years.

Hillstrand continues to enhance her understanding of neurology and is pursuing a Doctor of Nursing Practice (DNP) through Vanderbilt University’s School of Nursing focusing on Multiple Sclerosis in Alaska. Her career in neurology accelerated back in 2000 when she joined Marjorie Smith, MD, in private practice and subsequently formed Susitna Neurology. In

2007, she met Dr. Frank Ellenson, and within the year, they were planning to work together at a new center devoted to neurology.

Hillstrand has joined Alaska Neurology Center, which opened its doors to patients December 22, 2008. The Center has also grown to a team of 12 administrative and clinical staff, including four practicing clinicians in Neurology. All of the center’s neurologists are Board Certified by the American Academy of Psychiatry & Neurology and one is a Neuro-Psychiatrist, the only one in Alaska specializing with board credentials.

Looking across the Anchorage bowl now, one has a difficult time imagining the changes during Hillstand’s life and career. Her father, Earl Hillstrand, had arrived in 1941 as a civilian attorney for the Army, and like many of that era, he and his new wife chose to homestead, which included establishing a home and producing some form of agriculture.

“We planted a lot of potatoes and lived in a Quonset hut,” laughed Hillstrand.

The homestead, an area from Gambell to Lake Otis and from 15th Avenue nearly to Northern Lights, gave her plenty of room to grow. Her family also developed much of the commercial property on the Homer Spit, and after her father built the hotel, Land’s End, in 1957, the young Hillstrand spent summers working there before returning to Anchorage to attend school each winter. In addition, Mr. Hillstrand represented Anchorage in the Alaska Legislature from 1957, before statehood, until his death in 1973. Of all of her family’s high profile endeavors, perhaps the most visible today is on the Discovery Channel’s, Deadliest Catch, where nephews Jonathan and Andy run a crew aboard the Time Bandit, a vessel built by her brother, John.

“I’ve had tremendous opportunities in Alaska,” said Hillstrand, “and it feels good to look out the window across the medical complex toward the mountains and know I’m doing something to return the favor.”

Referral INFORMATION: ALASKA NEUROLOGY CENTER 3841 Piper St Suite T345 Anchorage, AK 99508 (907) 565-6000 or toll free 866-977-2562 phone/fax www.akneurologycenter.com info@akneurologycenter.com

May 2009

Alaska Nurse • Page 7

Local Nurse Provides Care Around the World With Doctors Without Borders Jennifer Pahl, an Emergency Department nurse at the Alaska Native Medical Center in Anchorage writes about her experience working with the international medical humanitarian agency Doctors Without Borders/Médecins Sans Frontières (MSF).

Jennifer Pahl & co. at Markounda IDP Camp. Photograph used with permission of MSF.

Author in Darfur while stationed at El Geneina MSF Hospital. Photograph used with permission of MSF. From the outset of my nursing career I have always had a passion for humanitarian work and international health and it was my experience with the Peace Corps in Burkina Faso that inspired me to apply my skills as a nurse to healthcare in the developing world. Working with MSF has provided some of the most challenging and most rewarding experiences of my career. My first assignment with MSF was in 2001 in the Democratic Republic of the Congo (formerly Zaire) where I was working as part of a medical team dealing with a recent cholera outbreak. MSF had been working in the DRC since 1981, twenty years later insecurity still reigned and the countries health system remained in tatters after years of civil war and government neglect. With even the most basic health care services lacking in many areas, MSF worked in both government and rebel held territory on a wide variety of medical programs. The emergency response to this cholera outbreak in the Katanga province was part of MSF’s wider district health projects in the country, designed to fight disease.

My medical team was responsible for treating cholera patients with oral rehydration solution, which was also given intravenously in severe cases. As there is no effective vaccine against cholera, MSF strives to prevent its spread by interrupting the fecal-oral cycle of the bacteria.

MSF’s response to this outbreak incorporated this preventative approach by working alongside the medical logistics team to provide health education as to how to prevent diarrhea. We also worked with the community to ensure they have sufficient numbers of pit latrines. Obviously provision of safe drinking water was essential to the containment of the spread of the outbreak so information was provided to the villages as to how to disinfect local wells.

My next two missions were in Sudan in 2003, first as a field coordinator in a Sleeping Sickness program (African trypanosomiasis) in the south of the country and then in the northwest of Sudan in the Darfur region where tens of thousands of people fled from violence and settled in camps.

When I arrived in Darfur, MSF was working in 24 separate locations and was serving around 500,000 displaced people. The situation was dire and the people lacked the essentials of food, water, and medical care. The first thing I was involved in was carrying out an assessment of the medical and humanitarian needs of the burgeoning displaced population. The hospital that our team opened included a therapeutic feeding center and a pediatric unit where we treated severely malnourished children—many of whom had complications of malaria or respiratory tract

infections. It was immediately obvious that setting up a hospital was not enough and that more had to be done to reach the scattered population throughout the 12 camps. We began to visit each of the 12 camps regularly, seeking out sick and malnourished children, stabilizing them on the spot and then transporting these patients to the hospital using the MSF ambulance. As time passed, this program became more developed, known and trusted, allowing us to reach out to more areas.

Each of my five assignments with MSF has been very different as have the challenges associated.

In Nigeria, when I orchestrated an outpatient nutrition program it was the shear volume of people trying to access the services that MSF were providing that proved the major difficulty.

Arriving at dawn to the feeding centers there were hundreds of women and children waiting for us.

We took care of the babies who were in critical condition first and those needing urgent care were transferred to the MSF hospital which was about 2-3 hours away. The work was extremely intense but we managed to treat thousands of babies in the eight weeks I was there, the impact we made was thanks largely to the Nigerian staff that were an honor to work with.

One theme that has been evident to me throughout my work with MSF is the staunch commitment that local health care workers have to serving their own communities. This devotion is all the more evident in times of danger and extreme hardship. In the Central African Republic a weekly mobile medical clinic set up by my team was reduced to a monthly visit due to banditry on the roads. The people in the surrounding community were suffering terribly because we couldn’t get there regularly as it was simply too dangerous for the team to travel to the site. In response to this dilemma, we hired locals in each village to run a health site to ensure there was some form of health care available during the absence of the team. These workers were given bikes so they could come to wherever we were to receive training and pick up medicines. Their jobs were treacherous yet without the bravery that they displayed we would have been unable to provide care to these communities.

The various assignments I have taken in Africa have had a profound effect on how I practice nursing. In the many years I have lived and worked in Africa, it has honestly shown me a compassion and desire to help. I have had the opportunity to meet both resilient patients and inspiring health care practitioners, showing me that even in the most demanding and seemingly impossible health care situation, an organization like MSF can make a true impact one patient at a time. The work of MSF delivers immediate benefits for communities where they work.

I am currently working at the Alaska Native Medical Center in the Emergency Department, where I feel we are giving care quite comparable with MSF. I see so many similarities in working with the native population here in Alaska; a focus on meeting the needs of an underserved population. The challenges I have faced abroad have made me stronger for the work I am doing back home.

DOCTORS WITHOUT BORDERS SEEKS NURSES, NURSE-MIDWIVES, AND NURSE-ANESTHESISTS 9-12 month commitment FOR REQUIREMENTS AND APPLICATION: www.doctorswithoutborders.org/work/field

Page 8 • Alaska Nurse

May 2009

Environmental Health, Health History and Potential Environmental Hazards in Alaska

by Patricia M. Hogan BSN, RN Public Health Nurses spend time investigating the effects of food borne illnesses, infectious disease outbreaks, and fielding questions about poorly functioning septic systems. The purpose of this article is to plant seeds of knowledge which suggest that environmental health affects each of us professionally as nurses, as family, as community members; it also affects us as advocates, policy makers and implementers of policy. We have the same obligation to society, and all families, as did Florence Nightingale and Lillian Wald1 (1867-1940) in their times.

Nurses repeatedly hear the term “environmental health,” and when we hear the term, we think of water, air, land and chemicals. However, according to the World Health Organization (WHO), the term is much more inclusive: Environmental Health comprises those aspects of human health, including quality of life, that are determined by physical, chemical, biological, social, and psychosocial factors in the environment.

It also includes the theory and practice of assessing, correcting, controlling and preventing those factors in the environment that can potentially affect adversely the health of present and future generations.

Environmental Health Services are those services which implement environmental health policies through monitoring and control activities. They also carry out that role by promoting the improvement of environmental parameters and by encouraging the use of environmentally friendly and healthy technologies and behaviors. In addition, they have a leading role in developing and suggesting new policy areas.2 Given its broad scope, the goal of environmental health is to implement environmental health policies through monitoring and control of activities. Since the role of Environmental Health Services is to promote the improvement of environmental parameters and to encourage the use of environmentally friendly and healthy technologies and behaviors, the roles for nurses in developing and suggesting new policy areas are many.

This article has several purposes: 1. To define environmental health and how it relates to nursing.

2. To introduce case studies of environmental illnesses and environmental health hazards that can be misdiagnosed as other illnesses.

3. To discuss causes of environmental health problems, describing the four classes of hazards affecting Alaskans.

4. To present the elements of an environmental occupational health history to more readily identify these health hazards.

The WHO definition is comprehensive. As nurses we address health in a holistic manner and meet more than the physical needs of our patients, family, and friends; we serve the whole of society.

Florence Nightingale was the first environmental nurse who addressed the full spectrum of nursing. She placed great emphasis on the nature and quality of a patient’s physical environment as contributing to determinants in outcome of recovery and health (Nightingale, 1860).3 Today in the 21st Century what are the environmental causes of disease? According to Conant and Fadem (2008): one way to think about causes of environmental health problems: • scarcity of essential things we need for a healthy life, such as clean air, and water, healthy soil and forests, safe and comfortable shelter and safe working conditions.

• excess of harmful things we do not need, such as trash, toxic, chemicals, pollution, and junk food.

“Improving environmental health depends on people preventing the conditions that cause both a scarcity of essential resources for life and an excess of pollution,” according to Conant and Fadem (2008).4

The environmental hazards of concern for this article fall into four classes: chemical, physical, biological, and psychosocial. These hazards may be naturally occurring, such as sunshine, radon; manmade, such as particulates and gases released into the environment from auto exhaust; industrial sources, such as hospital medical wastes or tobacco smoke; and childhood lead poisoning, childhood and occupational induced asthma, repetitive motion injuries, stress, and violence.

As early as 1979 the Department of Health and Human Services Surgeon General’s Report on Health Promotion and Disease Prevention noted, “There is virtually no major chronic disease to which environmental factors do not contribute, directly or indirectly” (DHHS, 1979, p 105).5 The effects of environmental hazards on the health of the community may generate public controversy.

Concerned citizens organize communities to protect health, legal, and financial interests, e.g., Love Canal, New York with toxic waste; Times Beach, Missouri with dioxin contamination; and contaminated water in Wolburn, Massachusetts. Situations such as these are considered population based and leave many nurses (with limited exposure to public health issues) unable to discern their role. One goal of this article is to expose Alaskan nurses to the knowledge and to offer guidance to bridge this gap between caring for individuals and populations.

I will begin with the introduction of several case studies dealing with environmental health issues. The following information is presented by the Agency for Toxic Substances and Disease Registry from the US Department of Health and Human Services and web site.8 A 67 year old man is brought to the Emergency Department (ED). The patient is experiencing ataxia, dizziness, and vomiting.

He is hyperventilating. On physical exam, he is well nourished, agitated, and disoriented.

The neurological exam is otherwise normal. He demonstrated no nystagmus and all other systems were within normal limits after eating lunch at the local airport the preceding day.

The history is provided by a friend who transported the patient. The patient complained of dizziness and began vomiting the night before. In the morning the patient was hyperventilating and continued to vomit. Because two other people had collapsed at the airport that morning and were taken by ambulance to another hospital; the friend wondered if the food at the airport cafeteria was responsible for the illness. Both he and the patient had hot dogs and coleslaw, but the friend states he feels fine.

Less than 30 minutes later a 4 year old boy is brought to the same ED. On exam the child is sleepy but arousable. There is no evidence of trauma or focal neurological signs nor other physical signs. The parents report they were attending the local fliers’ club luncheon at the airport. When they found the child staggering and incoherent, they rushed him to the ED. On the way he vomited in the car.

The Health Department identified the water at the airport as contaminated with ethylene glycol.

The construction crew hooked up the water from the heating system to the drinking system.

The concentration of ethylene glycol measures as 9% (90,000 parts per million, p.r.m.). The Environmental Protection Agency has an ethylene glycol drinking water quality guideline of 7 parts per million. The parents admitted the child was not supervised and wine and cocktails were served at the airport. Ethylene glycol exposure could not be identified as a potential exposure in this case, but ETOH was present.

Upon review of the signs and symptoms presented by the adult and child, one might not think about an environmental contaminate as the cause of illness.

Consider the following case: occurring in Alaska last year: A young mother presents to her local health care provider for a TB skin test so she can volunteer at the preschool. The test came back positive. In Alaska a positive PPD is 10 mm of induration as opposed to 15 mm in the lower 48.Her result was 50 mm. This mother was referred to the local Public Health Department for symptom screen.

Her symptoms history dated back 4 months and two previous visits and with one diagnosis of pneumonia and a second diagnosis of bronchitis.

Because she presented with a positive history of chronic productive cough for greater than 2 weeks, fever and chills, unexplained weight loss, chest pain and fatigue; she was considered a possible active TB case. She was asked to remain at home with no contact with outsiders until the results of three sputa specimen tests were negative. All family members were also tested. Her sputa were positive 4 +, plus her 5 year old son’s chest x-ray indicated he had active disease, but was not contagious. The 4 year old daughter was treated as a contact with a positive PPD but not for active disease, Latent TB Infection.

This family was diagnosed and treated for a biological environmental infectious disease after is was accidentally diagnosed. If you don’t think TB, it is missed.

The third case can be reviewed at the University of Washington’s website: http://depts.washington. edu/opchild/case.html.7 Isabella, a 6 month old, arrived from Mexico with her mother. She is irritable and congested, and after an initial assessment is sent to the local emergency department with a working diagnosis of an upper respiratory infection with dehydration.

Isabella is discharged from the ED, only to return via ambulance later the same night. Her symptoms are perplexing: she tests negative for all analyses and cultures for infectious sources. Noting a similar experience of a toddler who “ingested a garden product containing an organophosphate pesticide,” a colleague suggests pesticide poisoning be considered.

What each case demonstrates is the importance of an accurate and detailed history and the consideration of environmental causes for disease or illness. This prevents missed opportunities to make the correct diagnoses that might influence the course of disease in some afflicted individual (by stopping exposure) and that might prevent disease in others (by avoiding exposure). Etiology distinguishes a disorder as an environmental illness. Unless an exposure history is pursued, the diagnosis might be missed, treatment may be inappropriate, and the exposure may continue.

Eliciting an environmental (Exposure) history is one of the most important actions a nurse takes.

This history should identify current and past exposures, have a preliminary goal of reducing or eliminating current exposures, and have a longterm goal of reducing adverse health effects. The “I PREPARE” pneumonic (Paranzino, 2000) consigns the important questions to categories that can easily be remembered: see (www.atsdr.cdc.gov) 8 Four classes of environmental hazards are reviewed in this article: chemical, physical, biological, and psychosocial. During the past 20 years, the EPA has authorized hundreds of new chemicals to be used within our environment.

Their findings suggest many of us are exposed to all four classes of hazards.

Chemical Hazards are identified through the science of toxicology which is a basic science that studies the health effects associated with chemical hazards. In health care, pharmacology is the study of human health effects, both beneficial and undesirable effects associated with drugs. We measure toxic effects for drugs and pollutants in similar manners. What is a safe dose or effective range for therapy versus what causes adverse effects from medication or pollutant chemicals.

How much mercury is safe to ingest, inhale, and or absorb? Nurses have been exposed to toxic substances frequently on the job. Many worked with antineioplastic agents back in the 70s without any precautions; 5FU was drawn up regularly by floor nurses. Anyone required to use ethylene oxide as a sterilization agent has exposure. Nurses in the OR are exposed to waste anesthetic gases, formaldehyde is used in dialysis units, and old glass thermometers frequently broke and were wiped up quickly.

Physical Hazards: noise, electromagnetic fields, and ionizating radiation are hazard nurses experience through direct exposure in the work place. Radiation is the foremost exposure when holding patients during x-rays, especially in the Environmental Health continued on page 9

May 2009

Alaska Nurse • Page 9

Environmental Health continued from page 8 ER, ICU, and OR. The second ranked occupational injury is back injuries.

Risk factors for back injury are gender, shift and weight related. Training and orientation regarding lifting techniques upon initial hire and upon reassignment would help prevent injuries according to Fuortes,L. (1994).10 Each of us must develop protocols to utilize appropriate ergonomics to prevent back injuries and prevent repetitive injuries; and we must request assistance when lifting and moving patients, equipment, and supplies.

The Alaska Bureau of Vital Statistics reports fatal injuries. These physical hazards are documented by the Department of Health and Human Services. These are preventable injuries or accidents and nurses can help prevent them. Nurses can play the part as educators and advocates on the job, within the home, and within the community. Alaska DH&HS offers training programs to prevent injuries and accidental death as do community organizations, such as the Red Cross, Alaska Women’s Resource Center, and Alaska Family Services.

The following chart describes the fatal injuries by age groups from 2001 to 2005. Using this information, nurses can help address these problems. These are environmental health issues and DHHS has programs to address them.11 Biological factors: Infectious diseases affect all nurses in all settings.

The Alaska Department of Epidemiology prepares many bulletins that are available on their website. The following chart is modified from the 2007 Annual Infectious Disease Report (January-December).

2006-2007 Alaska Annual Infectious Disease Report - Number of Cases By Region DISEASE

S.WEST

2006 07

AIDS*

2006 07

2006 07

ANCH/ MATSU

GULF COAST

S. EAST

TOTAL

2006 07

2006 07

2006 07

2006 07

0 2

2 0

2 3

2 10

2 0

0 0

46 30

CHICKENPOX**

NN 6

NN 3

NN 1

NN 16

NN 1

NN 6

NN 43

CHLAMYDIA

645 644

400 495

526 733

2494 2547

197 207

266 285

4528 4911

0 0

0 0

1 1

4 3

1 0

2 1

8 5

61 46

54 74

42 37

448 405

17 8

8 11

630 581

1 2

9 9

E. COLI GONORRHEA HEP B

0 0

0 0

0 1

6 6

2 0

HEP C***

30 36

22 14

139 126

704 626

207 183

72 156 1174 1141

HIV****

1 5

5 0

6 5

36 26

3 0

0 3

88 61

SALMONELLOSIS

0 3

3 10

9 16

48 46

13 6

10 6

83 87

TB

10 9

7 7

4 4

41 28

4 1

4 2

70 51

39111

23653

105468

363879

75548

69328

676987

POPULATIONS SOURCE16

Psychosocial Hazards are conditions that create a threat to the psychological and or social well-being of individuals or groups according to Rogers (2001)12. When a human attempt at adaptation to the environment fails, an adverse psychosocial response may occur. Responses to negative interpersonal relationships are often the cause of vague health symptoms.

Nonfatal violence in the health care workers environment is a serious problem that is underreported according to the US Department of Health and Human Services, National Institute of Occupational Safety, (1996).13 Workrelated stress or burn out as been defined as an important problem for many individuals according to Parks and Sparks, (1998).14 Alaska through the Department of Health and Human Services reports annually on fatal injuries and sexual and domestic violence. The following charts represent these facts. The Alaska Council on Domestic Violence and Sexual Assault funds a network of nineteen victim service programs in eighteen Alaska communities, collectively serving 235 communities throughout the state. During fiscal year 2007, this council provided services to 7,511 clients. Twenty-eight percent of the clients were children and one percent were adults aged 60 and over. Services provided included 24-hour emergency support, safe shelter, crisis intervention, children’s services, food and clothing, referrals and many other services. The following information aggregates the field reports from victim service providers and shows the types of incidents experienced by the clients.

The top three types of incidents were domestic violence, sexual abuse of children, and sexual assault toward adults.15

NORTHERN INTERIOR

Nursing specialties often see their own special brand of disease/ injury clients. These are called Sentinel Occupational Health Events. An Occupational Sentinel Health Event is a disease, disability, or untimely death, which is occupationally related and whose occurrence may: 1. provide the impetus for epidemiologic or industrial hygiene studies; or 2. serve as a warning signal that materials substitution, engineering control, personal protection, or medical care may be required.

There are specific occupational conditions covered by OSHA standards.

Not all occupations have guideline exposure standards.17 The single most important aspect of the approach to patients with potential occupational or environmental disease is to have a high index of suspicion and to follow through on that suspicion.

In conclusion, it is hoped this article will stimulate nurses to explore potential environmental and occupational health risks. This is accomplished by applying the nursing process as Florence Nightingale and Lillian Wald did to investigate, collect data, present valid data, to advocate and change policies affecting society as a whole.

REFERENCES 1. Jewish Women’s Archive. “JWA - Lillian Wald - Introduction.” <http://jwa.org/exhibits/ wov/wald/index.html> (April 8, 2009).

2. The University of Manchester, Occupational and Environmental health Research Group, http://www. agius.com/hew/resource/envhlth.htm 3. Nightingale, Florence. Notes on Nursing. New York, S. Appleton and Company, 1860. www. digital.library.upenn.edu/women/nightingale/nursing/nursing/nursing.html.Section: Health of House. p. 24 4. Conant, Jeff. Fadem, Pam: a Community Guide to ENVIRONMENTAL HEALTH. 2004.

Berkley, Cal., hesperian. p. 22 5. Surgeon General’s report on health, promotion and Prevention, 1979. DHHS, p 105 6. Agency for Toxic Substance and Disease Registry From the US Department of Health and Human Services. http://www.atsgr.cdc.gov/csem/csem/cseml.html. or www.cdc.gov and select case studies in environmental medicine.

7. Pacific Northwest Agricultural Safety and Health (PNASH) Center and the Pediatric Environmental Health Specialty Unit (PEHSU) in Seattle, Washington. Organophosphate Pesticides and Child Health: A Primer for Health Care Providers. http://depts.washington. edu/opchild/case.html.

8. Stanhope, Marcia. Lancaster, Community and Public Health, St. Louis, Mo, 2004, Mosby, p. 230, Paranzino, Grace 9. Pope. AM. Snyder MA. Mood LA, editors: Nursing, Health, and Environment, Washington, D.C. 1995, Institute of Medicine, National Academy Press 10. Fuortes, LJ Shi, Y. Zhang Ml, et al. Epidemiology of Back Compensation records and a casecontrol survey. Journal of Occupational Medicine. 1994, 36:9 pp 1022-1031 11. Division of Public Health, Department of Health and Social Services. Alaska. Bureau of Vital Statistics, www.hs.state.ak.us/dept/ipemo/injury_prevention/documents/ FatalChart01-05.pdf 12. Rogers B.: Municipal healthcare worker’s work related hazards; Start Art. Rev. 16 (1):143161, 2001 13. Lewy, RM. Employees at Risk: Protecting the Health of the Health Care Worker, 1991. Van Nostrard, Reinhold pp 112-126.

14. Parkes KR. Sparkes TJ: Organizational interventions to reduce work stress: are they effective? A review of the literature. Oxford, UK: University of Oxford, Health and Safety Executive, Contract research Report No. 193, 1998 15. Alaska Council of domestic violence and Sexual Assault:. Http://www.dps.state.ak.us/ cdvsa/docs/AnnualReport2007.pdf 16. Alaska Epidemiological Bulletin: http://www.epi.hss.state.ak.us/bulletine/docs/ rr2008_01pdf 17. Sattler, B. Lipsomb, Jane.2003. ENVIRONMENTAL HEALTH and NURSING PRACTICE, New York, Springer p 244, pp. 253-254

Page 10 • Alaska Nurse

May 2009

Membership Application

Notice to AaNA Members

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If you have not been getting email updates and information from the Alaska Nurses Association, or if your address has changed and you are a member, please contact Donna Phillips at Donna@aknurse.org.

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.

Go to aknurse.org For online CE Nursing News Alaska Nurse: on the web Alaska nursing links

Reminder from Alaska Nurse Alert System

Numerous Events Should Prompt our Readiness!

As of this newsletter, Mt. Redoubt has had over twenty major eruptions causing ash fall in many towns and air traffic closure. Do you have masks? Do you have extra prescription meds? If air traffic was closed for an extended period of time, how prepared are you?

Recently, someone suggested taking just 3 pills out of every prescription and asking for an early refill by 3 days, (most prescriptions can be filled early by that amount of time) to accrue extra medication to last two weeks. It is suggested that people have at least a twoweek supply.

March 27 was the 45th anniversary of the 2nd largest earthquake in the world. Do you have an emergency plan? Do you know what the expectations are for you at the work site? When is the last time you looked at your work place Emergency Operations Plan?

The Iditarod race is completed for another year. In 1925, it was a life saving “highway” for residents of Nome suffering from an epidemic of Diphtheria. Have you checked your immunization record recently? Is it current?

And finally, a good time to do an update and assessment of home supplies is when the clocks change.

Have you checked your emergency supplies? Do you have enough for you and your family to be on your own for 72 hours? Some emergency planners are now suggesting 2 weeks in case of a major disease outbreak.

Alaska is a unique, harsh and isolated place to live.

With all of its beauty and wonder there are challenges.

We have to be self-sufficient. If you are under the assumption that you have “camping gear” so you are prepared, take a look. Many people find that their gear is lacking for any extended period of time or it’s scattered in many locations. Getting prepared takes time and is a process. One suggestion is to do one or two small tasks or purchases each month. One good web site that has a good checklist is www.ready.gov .

Start now~~~~~~~ GET PREPARED!

May 2009

Alaska Nurse â&#x20AC;˘ Page 11

AaNA Legislative Report

by Pat Senner, ANP, Committee Chair and Caren Robinson, AaNA lobbyist This was both a successful and disappointing legislative session. On the positive side, good progress was made on HB 50 (sponsored by Representatives Wilson, Gara, Tuck, Peterson, Lynn, Seaton, Gatto, Munoz, Gardner, Ramras, Forter and Kerttula) and SB 12 (sponsored by Senator Davis) [see page one].

Both of these bills would limit Representative overtime for nurses. SB 12 Peggy Wilson, made it through Labor and RN, Wrangell the Commerce and Health and original sponsor Social Services committees in of HB 50. the Senate and HB 50 made it through House Health and Social Services. Both bills ended the session in the Finance committees.

House finance co-chair Representative Stoltze has set up an interim committee to deal with any remaining issues. He appointed Representatives Joule, Fairclough, Foster, Gara, Hawker and himself to this. Hopes are that HB 50 will be ready to move out of finance committee early next year.

We want to particularly thank Representative Wilson and Senator Davis and their staff for their hard work on these bills.

Denali KidCare (SB 13) did not fare as well. At the beginning of the session we had great hopes that there would be an increase in the eligibility criteria for Denali KidCare after Governor Palin announced her support for this increase, but though SB 13 made it through the Senate, it was held in the House by Representatives Keller and Herron, the co-chairs of the Health and Social Services Committee. Without the passage of SB 13, approximately 1,200 children and 450 pregnant women will not have health insurance this year.

HB 35, Parental Notification and Consent for Minorâ&#x20AC;&#x2122;s Abortions, moved from the House and was held in the Senate Health and Social Services Committee. The committee will be working on the bill over the interim. The sponsor, Representative Coghill, introduced a committee substitute, which moves the bill toward a parental notification-only bill, but still has problematic sections, including a 48-hour waiting period and a judicial bypass.

SB 139, Incentives for Certain Medical Providers, establishes the health care professions loan repayment and incentive program, which will include provisions for registered nurses, and advanced nurse practitioners. The bill passed one committee and will be held in Senate Finance over the interim. The bill comes with a 7 million dollar fiscal note, so whether it progresses next year will probably be determined by the health of the economy.

We want to thank our two outstanding lobbyists, Caren Robinson and Mark Hickey, for their help in guiding our legislative priorities. They have shown considerable patience in dealing with a group of nurses and our various work schedules and priorities. They definitely share our passion for improving healthcare for all Alaskans.

Thanks also to everyone for your hard work during session by being willing to call, testify and send support messages when we asked! Stay tuned for ways to help move HB 50 and SB 12 forward so that next session we can have success after working for 5 years to improve working conditions for nurses.

Page 12 • Alaska Nurse

May 2009

University of Alaska Nursing Graduates

The University of Alaska, conferred degrees on the following Anchorage students last May and AAS outreach students last December.

As of our deadline, names of awardees for the Spirit of December 2008 AAS Outreach Graduates from Fairbanks, Bethel, Sitka, Kenai and Kodiak Evelina Susie Achee0 Jennifer Christine Alley Muriel Lynn Bell Teresa Marie Best Amber Klein Blackhurst Kimberly R Bower Danica R Broerman Laura Jean Buehler Rea Calkins Sara Marie Carlson Sabrina Renee Christiansen Sherron Lan Collins Lisa Ann Cooper Melissa Dawn Cope Jennifer J Denny Mary Minnie Devlln Theodore John Domke Diana Lynn Drath Aimee Jo Faulkner Jacqueline Ann Gilles Rachel Lee Grieme Charlotte A Harvey Peter M Harvey Aloysa M Harwood Sandra Olivia Hoedel Sarah Lynn Karpstein, Nichol LeeAnn Kelough Carlene J Mazon Gracie Olga Marie Nelson Molly B Noyes Shannon Lee O’Neal

Nursing, PEER and Director’s Award were not available.

They will be published when they become available.

Our sincere best wishes and congratulations to you all.

Welcome to our profession!

Michelle Anne Peschke Jeannine Marie Rennick Elise Michelle Shahan Tammy Lynn Sherbahn Amanda Lee Sipes Joy Morita Skjold Aaron L Smith Scott Allen Stohl Kimberly Dion Van Antwerp Dlrk J Vinlove BSN May 2009 Graduates Anchorage Nikki L Barnard, Yvonne F. Bay Lauren A. Bentz Jason D. Bibee Jennifer M. Brown Gena M. Brueggeman Rosemarie D. Buenarte Cynthia S. Crain Joel E. De Guzman Laurie M. Eason Henrietta Emokidi Karin L. Evans Ulyana J. Fefelov Cassie M. Fink Kayla D. Harnar Valerie E. Hattie Escorita L. Holder Nicolette J. Holmes Chelsea M. Johnson Andrea B. Jones Megan A. Kemp

Jorin K. Klawitter Agata M. Krozel April M. Laliberte Melisssa R. Lowther Kristine D. Lubaton Charlot K. Main Anya Martyshenka Meriam C. Middaugh Grantley H Quintyne Elecon L. Reformado Martha F. Rosenstein Iva K. Sebring Sean D. Slenkamp Tesfa M. Subani Emily J. Taylor Kirsten H. Wittenberger AAS May 2009 Graduates Jacqueline N. Ambrus Eric B. Atkinson Sutapa Bqanerjee Debra J. Barrow Katherine K. Boyle Lauri L. Bridges-Cham Renee L. Buchta Kim L Burnham Christine A. Clarke Claire A. DeHart Renee P. Francisco Jennifer A. Gardner Tara N. Halfmann Jennifer L. Hamberger Hope E. Harrington Matthew A. Kandrick

James D. Larabee Donald G. Lee Jessica A. Lewis Sheri J. Lisenbee Shelia J. Little Crystal R. Lujin Jennifer L. Maness Tara M. McCarron Jenny I. McDonald Jaycie L. Mee Stephanie A. Milbery Maria M. Nashalook Kristel A. Nelvis Raquel L. Osterbauer Rebecca M. Quinton Sherrie L. Soltis Darby J. Sullivan Becky Vannatten James A. Welt Cheridah M. Wilson MS May 2009 Graduates Barbara J. Anderson Patsy A. Cooper Laurie S. Edge Tara B. Henry Mary K. McCarty

May 2009

Alaska Nurse • Page 13

Resources Nursesbooks.org: publishing arm of ANA, releases new books.

[1/26/09] Guide to the Code of Ethics: Interpretation and Application; Faith Community Nursing: Developing a Quality Practice; and Genetics and Ethics in Health Care: New Questions in the Age of Genomic Health. Go to Nursesbooks.org for more information.

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Newly Revised Scope and Standards for Nursing Administration Published Nursesbooks.org, the publishing arm of ANA, is pleased to announce the long awaited release on March 31 of its 3rd edition of Nursing Administration: Scope & Standards of Practice. The book defines the scope and various levels of practice, outlines qualifications across settings, and provides standards of care and professional performance.

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Volunteers local – international ANA offers $175 discount off Global Volunteers Programs to its members and friends!

ANA is proud to announce its new partnership with Global Volunteers. Work alongside local people on lifeaffirming international service projects for one, two or three weeks. Use your health care background, teach conversational English, care for at-risk children or help on a labor project. Health care professionals are needed to provide basic care to impoverished newborns, children and their parents. Global Volunteers offers year-round volunteer programs on six continents and 20 countries. Learn more and choose your volunteer opportunity! Visit http://www.globalvolunteers.org/ana. htm or call 800-487-1074 for more information.

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NEEDED: A Few Good Volunteers Your American Cancer Society is at work across Alaska to provide programs aimed at reducing the risk of cancer, detecting cancer as early as possible, ensuring proper treatment, and empowering people facing cancer to cope and maintain the highest possible quality of life. Volunteers pay a critical role in the success of the society and its programs!

Volunteers can play various roles on a short-term or ongoing basis, but either way it can be an incredibly rewarding experience for both the volunteer and the patients receiving services. Please take a moment to consider becoming an American Cancer Society volunteer and joining in one of the programs described below.

• Become a Volunteer Patient Navigator!

The American Cancer Society, in partnership with local hospitals, is looking for volunteers to help guide cancer patients, families, and caregivers through the cancer experience.

These volunteers are trained by the American Cancer Society and are available on-site at local hospital Cancer Resource Centers to provide patients and caregivers a “one-stop source” for excellent cancer-related information and resource assistance.

• The American Cancer Society’s Road to Recovery program provided over 700 rides for cancer patients in Anchorage during 2008! Our heartfelt thanks go out to all of our drivers for their great service! Please consider being volunteer driver and a part of this terrific team!

• No one should have to face breast cancer alone.

Reach to Recovery volunteers are breast cancer survivors who are trained to provide information and support to women or men who have been diagnosed with breast cancer or who may be facing a breast cancer diagnosis. These volunteers serve as role models—they are people who have survived breast cancer and who continue to live productive lives. Volunteers may meet with a new patient face-to-face, by telephone or email.

• The American Cancer Society helps women cancer patients cope with the side-effects of cancer treatment by providing wigs at no cost to women who are experiencing hair loss and do not have the means to purchase a new wig. Volunteers are needed to help sort, clean, and style donated wigs, and also to help women find a suitable wig in our supply, determine a proper fit, and discuss wig care.

Training will be provided. Currently there are wigs available at the American Cancer Society Office, Providence Alaska Medical Center, and Alaska Regional Hospital.

For more information and to volunteer for any of these programs and services, please call your American Cancer Society at 1-800-ACS-2345 or in Anchorage, Lea Anne McWhorter at 273-2077 or Amanda McDade at 273-2069.

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Centers for Medicare & Medicaid Services has a new educational resource 2009 Electronic Prescribing Incentive Program— that has been posted to the Electronic Prescribing Incentive Program section page on the PQRI Web page.

This Fact Sheet provides detailed information on how to participate in the 2009 E-Prescribing Incentive Program. To access this new, and all, available E-Prescribing educational resources, visit http://www. cms.hhs.gov/PQRI on the CMS Web site and click on the Electronic Prescribing Incentive Program tab. Once on the E-Prescribing page, scroll down to the “Downloads” section and click on the “2009 Electronic Prescribing Incentive Program Made Simple” link. [AANP SmartBrief, 2/10/09] ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■

FDA Public Health Advisory The U.S. Food and Drug Administration issued a Public Health Advisory on transdermal patches and MRIs after learning that a warning was missing on some patches that contain aluminum or other metals in their non-adhesive backing. The metal in the backing isn’t attracted to the magnetic field in the MRI system but the metal can conduct heat and so it can cause burns.

Several people have reported receiving skin burns at their patch site when the patch remains in place during an MRI scan. [AANP SmartBrief 3/10/09] ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■

Call for Applications—2009-2010 IOM/ANA/ANF/AAN Scholar-in-Residence This Scholar-in-Residence program provides a year-long leadership opportunity in health policy at the Institute of Medicine of the National Academies.

It is designed as an immersion experience to facilitate nurse leaders engaging in a prominent role in health policy development at the national level and their interaction with other health fellows and scholars.

Complete applications should be sent electronically to the American Academy of Nursing by June 30. For more information and application criteria, visit IOM Scholar Information.

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The Road to Health Toolkit (Kit El camino hacia la buena salud) was developed by the National Diabetes Education Program to assist community health workers in providing outreach education to African American/ African Ancestry and Hispanic/Latino communities -- two groups at higher risk for Type 2 Diabetes. The toolkit features reliable, culturally appropriate and easy-to-use materials that focus on making healthy food choices and increasing physical activity. Download the toolkit at www.ndep.nih.gov or order a single copy (shipping and handling will apply) by calling 888-693NDEP (6337).

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Worldwide Networking— Geneva, Switzerland, 1 April 2009—The International Council of Nurses (ICN) is pleased to announce the launch of the ICN Telenursing Network today during a keynote address at the Med-e-Tel Conference in Luxembourg.

Members of the new ICN Telenursing Network will collaborate with the International Society for Telemedicine and eHealth (ISfTeH) Telenursing Working Group, and other professional and industry organizations, to advance the use of telehealth technologies among nurses worldwide. An ICN Telenursing Network Advisory Group, composed of telenursing representatives from different parts of the world, will provide leadership and direction for the work of the network.

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New Nurse Residency Program May Improve Retention of Nurses in Rural Facilities Rural nurses are required to have a breadth and depth of knowledge unparalleled in other specialty nursing fields. The rural nurse is often required to manage complicated patient conditions using limited equipment or technology while simultaneously coordinating care within a variety of social and cultural networks unique to the rural community. The immense generalist role of the rural nurse often leads to early burnout and high turnover rates when compared with more urban nurse roles (up to 65% in the first year of practice). On the other hand, residency programs have been shown to be an effective means of reducing the turnover of new and transitioning nurses. When a nurse participates in a residency program, they are provided with extended support and training which helps to reduce stress while increasing their confidence and proficiency.

And so, it is with great excitement that Idaho State University (ISU), in partnership with health organizations throughout the Northwest, has developed the Northwest Rural Nurse Residency (NWRNR)

Program. The NWRNR is a unique program for many reasons, not least of all is that residents and preceptors can receive all of their training ‘at home’ in their own facilities and communities. Using new technologies like web-conferencing, telemedicine and high tech simulation, participants don’t have to travel to an urban center, or even across town to benefit from the 64 hours of seminars and continuing education electives. Additionally, all 104 hours of the supervised clinical experience are completed in the nurse’s ‘home’ facility. Both residents and preceptors receive topnotch training by rural nursing experts from across the country. Program faculty and staff provide a supportive and informative role for preceptors, residents and nurse administrators to help ensure successful completion of the 12-month program. While resident’s benefit from increased training, accelerated skill acquisition and reduced ‘new role’ stress, preceptors are supported with training, mentorship, certification, an honorarium and regional recognition.

Due to the high tech convenience of the NWRNR training, participating facilities are required to have high-speed internet available to both the residents and preceptors as well as systems in place to support nurse education. Preceptors must be experienced rural nurses with at least two years in the facility and a license in good standing. Residents must have less than one year at the facility and be a new graduate, re-entering the profession, or transitioning from an urban setting.

Applications are accepted on a first-come, first-served basis, so apply today! Be one of the first facilities in your area to boast the employment of rural nurse specialists while enjoying the benefits of lower nurse turnover.

Call the ISU Office of Professional Development for an application or more information at (208) 282-2982, email at NurseOPD@isu.edu or visit the NWRNR website at http://www.isu.edu/nursing/opd/nwrnr.shtml ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■

The Honor Society of Nursing, Sigma Theta Tau International and Hill-Rom Announce New Environment of Elder Care Nursing Research Grant Application Deadline: 1 July 2009 In continuing its mission to support the education of nurses, the Honor Society of Nursing, Sigma Theta Tau International (STTI) will begin accepting applications for the Sigma Theta Tau International/Hill-Rom Environment of Elder Care Nursing Research grant on 1 April 2009.

Nurses who meet the following criteria are encouraged to apply by 1 July 2009: • Be a registered nurse with a current license • Have a master’s or doctoral degree or be enrolled in a doctoral program Allocation of funds is based on the quality of the proposed research, the future promise of the applicant, and the applicant’s research budget. Applications from novice researchers who have received no other national research funds are encouraged. Preference will be given to STTI members, if all other qualifications are equal.

Applicants must submit a completed research application package and signed research agreement via the online submission system. A final report and a completed abstract will be kept in the Virginia Henderson International Nursing Library with credit given to research grant partners in all publications and presentations of the research. Applicants must also be ready to implement the research project when funding is received. Funding is available up to US $9,000 and the recipient will be notified in September 2009. The grant will be presented during the honor society’s 40th Biennial Convention, 31 October-4 November 2009, in Indianapolis, Indiana, USA. For more information, visit http://www. nu rsi ngsociet y.or g /Resea r c h /Sma l lGra nt s/Pages/ EnvironmentofCare.aspx or contact Tonna Thomas, grants coordinator.

Page 14 • Alaska Nurse

May 2009

Upcoming Events Health Care Access: Nurses Creating Solutions June 15-17, 2009 Sheraton New Orleans Hotel To register online (day rates are available) and download the conference brochure visit www. nursingworld.org/PolicyConf .

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AANP 24th National Conference June 17 to 21, 2009 Gaylord Opryland Nashville, Tenn.

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Alaska Nurse Practitioner Association’s 26th Annual Conference September 24, 25, and 26th, 2009 Anchorage Downtown Marriott Joel Weintraub, with a Master’s Degree in Physiology and a Degree in Health Education will be the motivational keynote speaker who will discuss the magical benefits of incorporating humor in our lives and will offer an additional presentation reviewing the new risk factors for heart disease. Back by popular demand are specialty tracks in psychiatry, pediatrics and women’s health. A new pharmacology track has been added to this year’s conference. The pharmacology track will include pharmacologic management of diabetes, hypertension, arrhythmias, congestive heart failure and dermatologic conditions. Join your colleagues from across Alaska and the lower 48 for continuing education, networking, and a good time. For complete conference brochure and registration information, go to: alaskanp.org Update—ANPA Going Green for 2009 Annual Conference According to Maggie Barnett, 2009 Conference Chair, the Alaska Nurse Practitioner Association is going GREEN at their 26th annual educational conference to be held September 24-26, 2009.

ANPA will demonstrate their concern for the global environment and become environmentally friendly by distributing their usual paper materials via USB port to all registered attendees prior to the conference. Early registration will be key to receiving the USB ports in advance; late registrants will receive them at the conference. If you have any questions, comments or suggestions please feel free to contact Theresa Isaac, ANPA Conf. Admin Assistant at theresa525ak@gmail. com ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■

APIC Fall Conference Tuberculosis Clinical Update September 29-30, 2009 Marriott Anchorage Downtown The conference will bring national and international tuberculosis experts together to address the latest advances in TB diagnostics and treatments.

Dr. Anne Fanning, CM, MD, FRCP(C), emeritus Professor in the Faculty of Medicine and Dentistry, University of Alberta, Canada, will deliver the keynote address. She will share her experiences in the challenges of global TB control, including her work in Africa on TB and HIV and her successful efforts to establish STOP TB Canada.

Other distinguished faculty: Dr. Charles Daley, MD, National Jewish Medical and Research Center, Denver Dr. Anne Loeffler, MD, Legacy Emanuel Hospital, Portland Andrew Streifel, MPH, Hospital Environmental Specialist, University of Minnesota Dr. Elizabeth Funk, MD, MPH, Alaska TB Control Program Dr. Bruce Chandler, MD, MPH, Municipality of Anchorage Health Officer CME and CNE applications pending Contact: Sue Anne Jenkerson, Conference Chair 907-269-8000 sue.jenkerson@alaska.gov ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■

The Fourth European Nursing Congress, Older Persons: The Future of Care, is to be held October 4-7, 2010, in Rotterdam, The Netherlands. The central theme is older persons as the future of care.

In this congress, nurses from all fields of health care, including homecare workers, general hospital staff, mental health professionals and carers for the mentally disabled, are invited to share their methods and their research findings with regard to care for older persons. You can Google for more information.

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Alaska Statewide Nurses Conference October 16-18, 2009 Anchorage Hilton Contact the Alaska Nurses Association at 907-274-0827 for information.

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Sigma Theta Tau- Nursing Honor Society 40th Biennial Convention 31 October-4 November 2009 Indianapolis, Indiana ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■

May 2009

Alaska Nurse â&#x20AC;˘ Page 15

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 via 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.

To whom it may concern, I am Sandra Camp, Foster Care Licensing Specialist and I am writing this letter to see if there might be any nurses who might be interested in providing foster care for medically fragile children. Qualified people to take care of medically fragile children are in short supply these days. I was just thinking that maybe some nurses who are retired or are getting close to their retirement time frame would like to work out of their home. Perhaps nurses, who are near to their retirement, but want to continue to work and

by doing this they could right out of their own home. Of course there would be some qualifying parts to go through, but working nurses should pass the most critical hurdle and that would be their background check. Additionally, but not necessarily a barrier to licensing their home as a foster homeâ&#x20AC;&#x201D;we are also looking for some homes that are ranch style for the children who would be wheelchair dependent.

If there are any folks interested in this concept, please have them call me at 564-6832. I would be happy to talk to anyone who is interested and I would also be the person licensing their home.

Sincerely, Sandra K. Camp Foster Care Licensing Specialist Hope Community Resources, Inc. 540 W. International Airport Road Anchorage, Alaska 99518-1110 1-907-564-6832 DL & VM 907-564-7429 Fax Email: scamp@hopealaska.org Hope webpage: http://www.hopealaska.org