Nursingmatters June/July 2016 • Volume 27, Number 5
www.nursingmattersonline.com
INSIDE:
Nursing needs new leaders
2
LPN Survey results
4
Take a deep breath
6
Remember Ruby McKenzie
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7
Tracks offer help to bachelor of nursing Lisa Mihlbauer and Sylvia Forbes
The Institute of Medicine Future of Nursing Report recommends that 80 percent of registered nurses have a bachelor’s of nursing degree by the year 2020. The Wisconsin Center for Nursing 2014 RN Workforce survey of all registered nurses licensed in Wisconsin noted that 44.1 percent have a baccalaureate degree and another 11.7 percent have a master’s degree or higher. Multiple studies suggest that barriers to bachelor of nursing completion include cost, time, family commitments and lack of employer support. Because the demand for highly educated nurses is expected to outpace most other occupations during the next decade, it is essential to Sylvia Forbes find ways to remove barriers to the bachelor of nursing degree. The University of Wisconsin-Milwaukee College of Nursing is committed to removing barriers to bachelor of nursing educaLisa tion. It offers RN-to-BSN Mihlbauer curriculum in three modes – BSN@Home, BSN@Work and School, and the UW-Flexible Option. All program options are accredited by the Commission on Collegiate Nursing Education and the Higher Learning Commission.
BSN@Home offers online studies Six campuses in the UW-System offer the BSN@Home program online. BSN@ Home recently celebrated its 20 anniversary of offering the collaboration, which consists of the nursing programs at UW-Eau Claire, UW-Green Bay, UW-Madison, UW-Milwaukee, UW-Oshkosh, UW-Stevens Point and UW-Extension as administrative partners. The program provides a shared online core curriculum of upper-level nursing courses along with a home-campus mode to fulfill other requirements for the bachelor of science degree. Students enrolled in the program through UW-Milwaukee receive their advising, financial aid and other student services through UW-Milwaukee. All nursing courses can be taken online with the exception of the final Capstone course, which is a hybrid course with four on-campus sessions
TROYE FOX
Former BSN@Home student Tanya Marie Kreil works in her apartment. She is a graduate of the RN-to-BSN program.
in addition to online work and clinical practicum hours. The flexibility of the online program allows students to balance work and family life while earning their bachelor’s degrees. “The UW-System has an excellent reputation and the BSN@Home program has allowed me to pursue my degree online while working full-time,” said Kimberly Siebert, RN, BSN, and a UW-Milwaukee College of Nursing BSN@Home program graduate. “The program is flexible and the instructors are supportive. It has provided me with the best education and I am happy with the choice I made and the education I received.” Visit http://bsnathome.com for more information.
BSN@Work and School offers personal help The UW-Milwaukee College of Nursing offers face-to-face RN-to-BSN program classes in the Milwaukee area at Froedtert and Aurora St. Luke’s Medical centers as well as at Milwaukee Area Technical
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June/July • 2016
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Nursingmatters GUEST EDITORIAL
Nursingmatters is published monthly by Capital Newspapers. Editorial and business offices are located at 1901 Fish Hatchery Road, Madison, WI 53713 FAX 608-250-4155 Send change of address information to: Nursingmatters 1901 Fish Hatchery Rd. Madison, WI 53713 Editor........................................... Kaye Lillesand, MSN 608-222-4774 • kayelillesand@gmail.com Managing Editor................................... Julie Belschner 608-250-4320 • jbelschner@madison.com Advertising Representative.................... Teague Racine 608-252-6038 • tracine@madison.com Recruitment Sales Manager.......................Sheryl Barry 608-252-6379 • sbarry@madison.com Art Director...........................................Wendy McClure 608-252-6267 • wmcclure@madison.com Publications Division Manager.................. Matt Meyers 608-252-6235 • mmeyers@madison.com Nursingmatters is dedicated to supporting and fostering the growth of professional nursing. Your comments are encouraged and appreciated. Email editorial submissions to klillesand@sbcglobal.net. Call 608-252-6264 for advertising rates. Every precaution is taken to ensure accuracy, but the publisher cannot accept responsibility for the correctness or accuracy of information herein or for any opinion expressed. The publisher will return material submitted when requested; however, we cannot guarantee the safety of artwork, photographs or manuscripts while in transit or while in our possession.
EDITORIAL BOARD Vivien DeBack, RN, Ph.D., Emeritus Nurse Consultant Empowering Change, Greenfield, WI Bonnie Allbaugh, RN, MSN Madison, WI Cathy Andrews, Ph.D., RN Associate Professor (Retired) Edgewood College, Madison, WI Kristin Baird, RN, BSN, MSH President Baird Consulting, Inc., Fort Atkinson, WI Joyce Berning, BSN Mineral Point, WI Mary Greeneway, BSN, RN-BC Clinical Education Coordinator Aurora Medical Center, Manitowoc County Mary LaBelle, RN Staff Nurse Froedtert Memorial Lutheran Hospital Milwaukee, WI Cynthia Wheeler Retired NURSINGmatters Advertising Executive, Madison, WI Deanna Blanchard, MSN Nursing Education Specialist at UW Health Oregon, WI Claire Meisenheimer, RN, Ph.D. Professor, UW-Oshkosh College of Nursing Oshkosh, WI Steve Ohly, ANP Community Health Program Manager St. Lukes Madison Street Outreach Clinic Milwaukee, WI Joyce Smith, RN, CFNP Family Nurse Practitioner Marshfield Clinic, Riverview Center Eau Claire, WI Karen Witt, RN, MSN Associate Professor UW-Eau Claire School of Nursing, Eau Claire, WI © 2015 Capital Newspapers
Nursing education call for action Sharon Chappy, PhD, RN, CNOR Dean and Professor, Concordia University WisconsinSchool of Nursing
• Dr. Sally Lundeen: Faculty at the University of Wisconsin-Milwaukee for 31 years, dean of the College of Nursing for 17 years, retiring in 2016. • Dr. Katharyn May: UW-Madison School of Nursing dean her entire 15-year tenure, stepping down in 2016. • Dr. Rosemary Smith: Faculty at UW-Oshkosh for 38 years; dean of the College of Nursing for 10 years, retired in 2015. • Dr. Deb Jenks: Faculty at Milwaukee School of Engineering for 14 years, Nursing Department chairperson for 12 years, stepping down in 2016. • Dr. Margaret Callahan: Nursing dean at Marquette University for seven years, interim provost from 2013 to 2015, left in 2015 to become provost of the Health Science Division at Loyola University in Chicago A collective 105 years of prime nursing education Sharon experience and 61 years Chappy of years of administrative expertise and institutional knowledge have been lost from Wisconsin nursing programs in just the past two years. The transition may not be noticed by the public or highlighted on the local news. However these women are thought leaders and action drivers who cooperatively spearheaded the movement of Wisconsin nursing into the 21st century and beyond. They tirelessly pioneered curricular innovations and nurse-led healthcare initiatives across the state. They led education, practice and research trends to meet expectations of a rapidly changing healthcare arena. Their schools, programs and faculty were continually improving methods to prepare new registered nurses, advanced-practice nurses, nurse educators and nurse scientists. It would take an entire edition of this publication to list the collective accomplishments of the nurse leaders listed above, but let me highlight a few innovations they spearheaded. The UW-System Nursing School deans led the development of the Collaborative Nursing Program, today called BSN@Home.
The program created the first University of Wisconsin-System to Wisconsin Technical College System transfer agreement in the early 1990s. It was the first bachelor’s of science degree program in the UW-System available almost exclusively through distance learning. BSN@Home is still highly effective, offering a standardized curriculum for nurses with associate’s degrees to earn bachelor’s degrees in Wisconsin. UW-Milwaukee College of Nursing established the first academic nursing center in the nation in 1979, and provided 30 years of crucial nurse-led health services to poor Milwaukee neighborhoods, also providing innovative clinical experiences for nursing students. UW-Milwaukee established the first online nursing PhD program in the nation in 2003. UW-Oshkosh’s accelerated online program for bachelor’s to bachelor’s in nursing was the first of its kind in the United States to be delivered online. The Doctor of Nursing Practice was the first doctoral degree awarded at UW-Oshkosh. A $27 million remodel provided expanded simulation and laboratory space for the nursing program, along with smart classrooms. Milwaukee School of Engineering-School of Nursing grew from 60 to 249 students in 12 years. An accelerated second-degree bachelor’s of nursing track began in fall 2013 to meet demands of nontraditional students. A Master’s of Science in Nursing with a concentration in Health Systems Management launched in fall 2014. Milwaukee School of Engineering houses a simulation-based education program used by hospital systems to advance RN skills in rapid response and care of critically ill patients. UW-Madison’s Signe Skott Cooper Hall opened in 2014; it was designed to transform the way nursing and health-professions students learn. The building offers the largest collaborative-learning classroom complex in the country, designed to support best practices in nursing and inter-professional health education. Classrooms are fully interactive and integrated with wireless and wired instructional technology, and outfitted with complete audio and video recording capabilities. They are designed to infuse team-based learning in all facets of undergraduate and graduate programs. The UW-School of Nursing won two national
innovation awards in nursing education in the past five years. The Wheaton Franciscan Healthcare Center for Clinical Simulation at Marquette University established a unique, inter-professional partnership benefitting both Marquette students and Wheaton Franciscan staff. Wisconsin’s first Doctor of Nursing Practice program began in 2008 at Marquette. Marquette created a partnership with Sojourner Family Peace Center to give nursing students an opportunity to work with victims of domestic violence. Marquette is launching a Doctor of Nursing Practice program for Nurse Anesthetists with the Medical College of Wisconsin to meet the needs of the community. These leaders led a movement to organize nursing administrators from all nursing programs across the state to speak in one collective voice when advocating for the needs of Wisconsin’s nursing education programs – called Administrators of Nursing Education of Wisconsin. It is with great trepidation that I ponder the magnitude of this transition and what it means to nursing education in Wisconsin. Effective leaders leave their organizations ready to carry on their mission, which these deans have done. However the current political climate in Wisconsin, including recent budget cuts and proposed changes to the tenure system, may negatively impact our schools’ abilities to bring exceptional talent into the pool from which future nurse leaders will be chosen. The desirability of a nursing dean position in Wisconsin may have decreased in recent years. At the same time, succession planning for nursing leadership in Wisconsin has not been as intentional as it could have been. This is partly because effective succession planning takes human and capital resources that have not been afforded schools of nursing. As of April 25, 2016, there were 26 position vacancies nationwide for deans, associate deans or directors listed on the American Association of Colleges of Nursing website. The challenges we are facing in Wisconsin are not unique. This editorial is not written to suggest that nursing education in Wisconsin is in serious danger. There will be people to fill these gaps and carry on. But concerns remain. In Wisconsin, 56.3 percent of
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LETTER TO THE EDITOR It is with great sadness that I read in the April 2016 NursingMatters that the (American Nurses Association) endorses (Presidential candidate Hillary) Clinton. Hillary Clinton loudly expresses her backing of Planned Parenthood and NARAL (Pro-Choice America, formerly known as
the National Abortion and Reproductive Rights Action League). Planned Parenthood is the largest abortion provider in the country and responsible for millions of deaths of babies. We as caregivers support life-giving skills to all we care for, including the
unborn of which many are future potential RNs. The American Nurses Association needs to rethink (its) stand, and support and care for life at all stages. Cecilia Peaschek-Maurer, RN, Manitowoc, Wisconsin
www.nursingmattersonline.com
June/July • 2016
Chappy
Not all work
continued from page 2 nurses are over age 45, meaning about half the current nursing workforce will retire in the next 15 to 20 years; new nurses will be desperately needed. Nursing schools across the country are working to increase enrollments to meet current and future demands for nurses. However nurse educators are also in short supply – we need more nurses to be educated to the level to teach the next generation of nurses. According to the Wisconsin Center for Nursing, as of 2014 only 2 percent of Wisconsin nurses were employed as faculty in schools of nursing. The American Association of Colleges of Nursing reports nursing faculty nationwide are older than nurses in general. By rank, professors with doctorates average 61.8 years of age, associate professors average 57.7 years and assistant professors average 51.5 years. Those who are left to lead nursing programs may be in the twilight of their careers, and their steps into leadership roles may be short-lived, contributing to future turnover. We need to continue the excellence these nursing leaders have established, to maintain the pipeline of highly skilled nurses and advanced nurses in Wisconsin. We need to attract younger nurses to academia and assure salaries for educators improve so graduate nurses entering their first professional positions are not making higher salaries than the faculty who worked tirelessly to educate them. We need to support legislation to fund advanced education for nurses in exchange for a commitment to teach nursing in Wisconsin. We need the public to recognize the potential impact this transition in dean leadership might have, and join in a call for action to make funding for nursing education a Wisconsin and national priority. With the recent departures of these deans, we have lost colleagues and mentors who significantly strengthened nursing education, practice and research. Only with our collective voice can we assure that the work of Drs. Sally Lundeen, Katharyn May, Rosemary Smith, Deb Jenks and Margaret Callahan will grow. Working together we can maintain top-notch nursing-education programs across the state to meet the healthcare needs of the people of Wisconsin and across the country.
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MARQUETTE UNIVERSITY
A Marquette student works with kids on Summerfest fairgrounds.
University offers unique nursing program MILWAUKEE – Marquette University will soon offer a unique program for professionals with non-nursing degrees to earn an accelerated master’s in nursing degree – in as few as 18 months. The expansion of Marquette’s “Master of Science in Nursing Second Degree Direct Entry for Non-Nurses” program allows students to earn a master’s degree through a combination of online coursework, along with hands-on labs and in-hospital clinical rotations. The Marquette program will have a student learning center and nursing simulation lab located in Pleasant Prairie, Wisconsin. The lab is expected to open in
fall 2016; Marquette is currently accepting applications for the program. Visit mastersnursing.marquette.edu to learn more about applying. “Marquette and the College of Nursing are excited to launch this new option as an extension of our already established graduate nursing programs,” said Dr. Maureen O’Brien, associate dean. “To be able to offer a (Master of Science in Nursing Second Degree Direct Entry for Non-Nurses) for greater numbers of students with non-nursing degrees allows us to be the difference for our students and community.” The program provides more
accessibility to students by offering online coursework and providing two additional start dates each year, O’Brien said. It’s scheduled to begin August 2016; a second class will start in January 2017. “At Marquette, our goal is to provide a program that fits the lifestyles of individuals who are dedicated to changing careers,” said Angela Becerra-Chvilicek, program site director. “This higher degree prepares graduates with the necessary leadership and clinical skillset to excel both professionally and financially in the health care industry.” Visit mastersnursing.marquette.edu or call 866-891-8438 for more information.
Notice of Vacancy for
NURSE CLINICIAN 2 Sand Ridge Secure Treatment Center Mauston, Wisconsin (Juneau County) Wisconsin’s Department of Health Services (DHS), Sand Ridge Secure Treatment Center (SRSTC) in Mauston, is seeking candidates for the position of Nurse Clinician 2. There are currently several vacancies available. This is an opportunity for nurses to work in a challenging and unique setting. SRSTC is a nationally recognized facility for the treatment of sex offenders committed under Wisconsin’s Statute 980. As a registered nurse, you will be utilizing the nursing process in the provision of routine and complex patient cares in both a clinic and skilled care unit setting. New nurses are provided one-toone orientation designed by a Nurse Clinician 4 that meets individual learning needs. An opportunity to work side-by-side with experienced nurses is also provided. Nurses at SRSTC are respected and valued for their knowledge, skill and contribution to the mission of SRSTC. To be considered for this position, you will need to create an account and apply online. For instructions please visit the State of Wisconsin website at http://wisc.jobs and refer to Job Announcement Code 1600590. The deadline for submitting applications is June 30, 2016. Materials will be evaluated and qualified candidates will be invited to participate in the next step of the selection process. EOE
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Nursingmatters
2015 LPN Survey report released
Results of the 2015 Wisconsin Licensed Practical Nurse Survey have been released. The survey was accomplished with significant support of key individuals and partners. Licensed Practical Nurses are a critical segment of the nursing workforce in the state. The report is sponsored by the Wisconsin Center for Nursing Inc. in partnership with the Wisconsin Department of Workforce Development. The Wisconsin Center for Nursing was assisted by the work of volunteer researcher Josie Veal PhD, RN, APNP – associate dean at Milwaukee Area Technical College-School of Health Sciences – and statistician Jeffrey B. Henriques, PhD, with the Department of Psychology at the University of Wisconsin-Madison. Their work on the critical report provided comprehensive information on the status of the LPN workforce in Wisconsin and recommends strategies to address future nursing shortages. There is a critical workforce need for LPNs to assist with decreasing healthcare disparities and address direct-care needs of clients in urban, metropolitan and rural areas. The biennial nursing-workforce survey, mandated by Wisconsin Statute Chapter 106.30, has provided data regarding LPN credentials, places of employment, and future plans for work, education and
retirement since 2011. The survey is constructed by the Department of Workforce Development and the data is collected by the Wisconsin Department of Safety and Professional Services. After data cleaning using exclusionary criteria, the results summarized for the 2015 Survey are based on 11,158 online responses. The LPN workforce remains predominantly female, at 94.8 percent, with the largest group of practicing nurses between the ages of 55 and 64 years old, with mean age at 49 years. There was a slight increase in the percentage of males and the number of Hispanic, Latino or Spanish nurses.
Clinical Adjunct Faculty, Lecturer – School of Nursing Clinical faculty are responsible for planning, implementing and the evaluating of assigned student learning experiences in the clinical setting in the traditional and/or post baccalaureate undergraduate nursing program(s). We currently have several open positions for faculty with expertise in one of the following areas: maternal‐child, psychosocial/behavioral health, and public health experience. The clinical faculty work in collaboration with the corresponding theory course instructor(s). Formal mentoring support is provided for new faculty along with significant faculty development resources. Qualifications: • Minimum of Master of Science in a nursing degree • Current license to practice as a registered nurse in the state of Wisconsin. • At least two years of full-time or equivalent direct care experience in nursing. • Previous teaching experience (clinical/didactic) preferred. PHYSICAL DEMANDS AND WORK ENVIRONMENT The physical demands and work environment characteristics described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Other Qualifications: Demonstrate multicultural competence – the awareness, knowledge, and skills needed to work with others who are culturally different from self in meaningful, relevant, and productive ways. The candidate must actively support the mission of the college by working with faculty, staff and students to share in our core values - truth, compassion, justice, partnership, and community. To Apply: Send a letter of application, resume, and references to: Edgewood College Human Resources – LRSN 1000 Edgewood College Drive Madison, WI 53711 E-mail: humanresources@edgewood.edu
Equal Opportunity Employer
Still, males only represent 5.2 percent of the LPN workforce. Racial/ethnic diversity of this workforce, although slightly better than registered nurses, still does not mirror the general population of Wisconsin, with LPNs represented by African Americans at 6 percent, Hispanic or Latino at 2.2 percent, Asian at 1.3 percent and Native Americans at 0.4 percent. The highest reported languages, other than English, are Spanish and American Sign Language. Among Wisconsin regional data, the median age of LPNs is lowest in the southern and northeast regions, at 47 years, and highest in the western region at 52 years. Statewide, LPNs have provided an average of 16.7 years of direct patient care; but the northern region has an average time for LPNs providing direct patient care at 17.7 years. Statewide and across each region more than 80 percent of all LPNs provide direct patient care. The primary work settings for LPNs in Wisconsin are extended care and ambulatory care. The highest degree earned for Wisconsin LPNs is the diploma in nursing, with 10,506 of survey responses, or 94.2 percent. In both the 2013 and 2015 surveys, consistently 23 percent of LPNs indicated a plan to pursue further nursing education within two years. Statewide 22.7 percent of LPNs plan to pursue further education in nursing by 2017. However the highest-ranked barriers to pursuing education
are cost of lost work and benefits, and cost of tuition, materials and books. Since 2011 the state has seen a decline in the number of newly licensed LPNs in Wisconsin. The rolling total of eligible first-time candidates for Wisconsin Board of Nursing-approved LPN programs has declined from 2012 – 21,883 – to second-quarter 2014 at 11,190. The primary function for 85 percent of LPNs is providing direct patient care, with an average number of years providing care at 16.7 years. But during the next 10 years about 49 percent – almost half – of those nurses will leave the bedside. There was an increase in the percentage of retired LPNs between 2013 and 2015. During the survey periods for 2013 and 2015, 75 percent of Wisconsin LPNs were actively working as a nurse. The three most significant factors for career decisions were 1) level of personal satisfaction/collegial relationship, 22.4 percent, 2) family/personal issues and pay, 13.8 percent. The LPNs have about 9.78 years in their
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Nursing
continued from page 1 College. A new partnership was also begun in 2015 between the UW-Milwaukee College of Nursing and All Saints in Racine, Wisconsin. BSN@ Work courses are offered in seven-week formats. Zeb Koran, DNP, MS, RN is vice-president of Patient Care and Nursing Practice at All Saints and has been a champion for promoting advanced degrees for her nursing staff. Dr. Koran states: “I am thrilled that we could partner with (UW-Milwaukee) to provide this opportunity to our nurses,” Koran said. “They appreciate the convenience of classes being onsite and the camaraderie that comes from being in a cohort. It is very exciting to watch them grow their knowledge and their dedication to the nursing profession and our patients. As a health care employer, it also helps us in our goal of increasing our number of (bachelor of nursing) prepared nurses.” Bachelor of nursing completion classes are offered at the Milwaukee Area Technical College through a unique collaboration. Milwaukee Area Technical College students receive guidance from a dedicated outreach advisor from the UW-Milwaukee College of Nursing. A UW-Milwaukee nursing leadership course co-taught by faculty from both the Milwaukee Area Technical College and UW-Milwaukee is offered as an elective for fourth-semester Milwaukee Area Technical College nursing students. The course meets the curriculum requirements of both the associate’s degree of nursing program and the bachelor of nursing completion program. Students who take this course have completed a required bachelor of nursing degree course prior to graduating from their associate’s degree in nursing program and are on the path to bachelor of nursing completion in a shorter time frame. Visit http://uwm.edu/nursing/ academics/undergrad/rn-bs for more information.
UW Flexible Option offers scheduling help The UW-Milwaukee College of Nursing is the only UW campus offering an RN-to-BSN degree program in the UW-Flexible Option. Because many registered nurses are non-traditional students with past college credits who are working in full-time jobs, traditional educational approaches do not always meet their needs. The UW-Flexible Option competency-based education model is a unique approach that
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June/July • 2016 can open access to specific groups of students who are not enrolled in traditional forms of higher education. The new program option began enrolling students in early 2014; 12 students have successfully completed the program. About 125 additional students are currently enrolled and making progress toward degree completion. Program length varies for each student. The first graduate completed the program in less than 12 months, while other students choose to work at slower paces and complete the program during a longer time frame. The UW-Flexible Option is a selfpaced competency-based degree program that allows students to progress toward a bachelor’s in nursing degree by demonstrating knowledge they have obtained through past and current coursework, by studying, through employment and through other learning experiences. The students progress toward a degree by successfully completing a series of faculty-created competency assessments that demonstrate mastery of required course and program outcomes. The program does not offer academic credit for life or previous nursing experience. However students receive credit upon the demonstration of clearly defined competencies required of bachelor of nursing-prepared nurses. Students can begin the program on the first day of any month; there are no mandatory logins or discussion posts. Student learning is not measured by time in class or time online, but by successful completion of assessments that demonstrate competency. “I have gained a lot of knowledge on the job,” said Carla Lundeen, RN, BSN and UW-Flexible Option graduate. “(UW-Flexible Option) lets you gain credit for what you know. It does not matter where, when or how you learned it – as long as you can use it to complete your assessments, you can move ahead.” One unique feature of the UW-Flexible Option program is that each student has a dedicated Academic Success Coach who provides mentoring, advises and gives assistance navigating through the program. The coach is the student’s first point of contact for questions and concerns, and is an important member of the learning team. Visit http://flex.wisconsin.edu/ degrees-programs/online-nursingprogram for more information. Lisa Mihlbauer, MS-Nursing, BSN, RN, IBCLC, CNE is the director of the RN-to-BSN Completion programs at the UW-Milwaukee College of Nursing. Sylvia Forbes, MSN, BSN, RN is the statewide BSN@Home program coordinator and a program manager at the UW-Milwaukee College of Nursing.
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June/July • 2016
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Nursingmatters
WHAT IF ...
Step One: Take a deep breath Brenda Zarth
Did your mother ever tell you, “Stop and take 10 deep breaths before you say or do something you might regret later.” It always worked. By the time I’d counted to 10 I wasn’t angry anymore. I was still frustrated, confused and hurt, but I could think more clearly. Breathing is done on auto pilot – or you can take control. Nice thing is you can take control anywhere or anytime; you don’t need any supplies, it doesn’t cost anything and you don’t need an appointment. Eastern medicine will tell you to breathe in to bring in energy, and breathe out to relax. We instinctively Brenda Zarth breathe in, but when scared or stressed we forget that our lungs are a closed system. We can’t bring in any more air until we exhale. I’ve been doing a little study lately when doing blood-pressure checks. I have my patient sit for five to 10 minutes and I check a baseline blood pressure. Then we do four to five slow deep breaths – breathing in through the nose and counting to three, and then out through pursed lips, counting to four. I then check a blood pressure again.
Eastern medicine will say to breathe in to bring in energy, and breathe out to relax.
I consistently see four to 20 points lower on recheck. The average is probably eight to 10 points. I tried the same thing with visual imagery. I told my patients to think about their favorite happy relaxing places – a nice beach or under a shade tree in the backyard. The guided imagery didn’t work as well; it seemed their minds would drift more easily to stress. If they focused on breathing and
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Survey
continued from page 4 current primary position, with an average of 18.39 years of experience. In both 2013 and 2015, the majority of LPNs reported geriatric and/or gerontology specialization – 48 percent. In Wisconsin, 65 percent of LPNs have received training in emergency-preparedness training. Regarding compensation levels, 75 percent of Wisconsin LPNs report an hourly wage ranging from $14.75 to $23.99 per hour. LPNs were instructed in the survey to identify compensation components of their principal job, which included salary and available benefits.
needed to count, the physical act of breathing seemed to drop the blood pressure. The 20-point drop came from a gentleman who was experienced with meditation and just told himself to relax. According to my acupuncturist and yoga instructor, Anne Adametz, Eastern medicine teaches that breathing is the fastest
continued on page 7
The LPN workforce in Wisconsin is vital for providing critical nursing services to health consumers within the state. The Wisconsin Department of Workforce Development has made the survey accessible to thousands of LPNs in the state. Thanks go to Wisconsin LPNs for completing the survey, and for the care they provide to patients and their families. Schools and organizations will utilize the information to advance nursing education and practice to assure a sufficient, competent and diverse nursing workforce for the people of Wisconsin. Visit www.wisconsincenterfornursing. org or email info@wicenterfornursing.org for more information.
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June/July • 2016
Reprint in a series written by Signe Cooper and introduced by Laurie Glass in Nursingmatters
Ruby M. McKenzie – 1895-1964 A pioneer public-health nurse, Ruby McKenzie may have served as the county nurse of more Wisconsin counties than any other person – in a career that spanned more than 40 years. She also served as an army nurse during World War I. McKenzie was born Oct. 22, 1895, near York Center in Dane County, Wisconsin, and grew up on a farm in Wood County, Wisconsin. After graduating from Wisconsin Rapids High School she enrolled in the School of Nursing at Ancker Hospital in St. Paul, Minnesota. Her public-health nursing preparation was from a short course offered by the Wisconsin Anti-Tuberculosis Association in Milwaukee. After serving as an army nurse at Camp Pike in Little Rock, Arkansas, during World War I, she began her long career as a public-health nurse. Many of Wisconsin’s early public-health nurses were veterans; it can be speculated that after their military experiences they were not content to return to private-duty nursing, where most nurses were then employed. McKenzie’s first appointment in public health was as the Barron County nurse. Her description of her early work appeared in a 1954 issue of the Waukesha Freeman. Epidemics of diphtheria, smallpox and scarlet fever were common in winter, and cases of poliomyelitis in summer. Traveling around the county was an experience, because in the 1920s there were few paved roads in Barron County. There was little attention to snow removal so driving her car in the winter was impossible. She often traveled in the sidecar of a motorcycle driven by a local citizen, who added one sled runner to the front of his motorcycle and another under the sidecar. On long trips she rode in the caboose of a freight train. After her experience in Barron County, she served as county nurse in Marathon County, followed by Washington, Kenosha, Columbia, Sauk and Ozaukee counties. She also spent a year as a public-health nurse in the state of Oregon. In 1950 McKenzie was appointed the Waukesha County nurse. When she retired 11 years later, the staff had grown from two to 10 nurses. Programs had expanded to include immunization clinics, well-baby clinics, classes for expectant mothers and an extensive tuberculosis-control program. Carmen Mockrud, who worked with McKenzie, believed she was ahead of her time in her forward-thinking ideas. Mockrud cited the development of the Waukesha County Health Department as an example. McKenzie helped organize and worked with a study committee to examine the advantages of establishing such a department. The committee recommended the formation of a county-wide health department, the first one in Wisconsin, with a fulltime medical director. Mockrud said she enjoyed working with McKenzie, and recalled McKenzie served as the public-health nurse in one of Waukesha County’s townships. She said she believed the firsthand experience helped McKenzie understand the challenges faced by the staff. McKenzie had high expectations of her staff, and supported them in their endeavors. She encouraged them to participate in nursing organizations and arranged for them to keep abreast of their practice by attending nursing conferences. She was among the first of the public-health agencies in the state to provide in-service education for her staff. Mockrud also recalled that when staff members were scheduled to drive out in the country, McKenzie would encourage them to look at the birds, flowers and trees to appreciate the beauty of the landscape. Active in local, state and national nursing associations, McKenzie was also a member of Altrusa. She was actively involved in the Presbyterian Church. She retired in 1961 and moved
Breath
continued from page 6 way of detoxifying the body. She cautions to start slowly; gently adjust your breathing to focus on releasing your breath fully. Ten deep breaths can help to calm the nervous system. She suggests 10 deep breaths at night, focusing on the exhale to help your body relax and slip into sleep. According to her, “we want the mind to follow the breath so that the mind is
no longer in charge; rather the flow of our body takes the lead and we become the observer. Focusing on your breath can reset the heart rate, hormones and emotions.” I think about singing – singing in the shower to start the day, singing in the car on the way to work. I can appreciate how good I feel exhaling to a positive uplifting song or two on the way to work, and how it seems to set the stage for the day. Anne suggests chanting can be used to
Ruby McKenzie
to Everett, Washington, to be near her sister and brother-in-law. She had been diagnosed with colon cancer, and succumbed to the disease in September 1964. One of Wisconsin’s pioneer public-health nurses, Ruby McKenzie had a distinguished career. She understood the important role of the public-health nurse in safeguarding the health of the community. The author thanks Carmen Mockrud and Lucille Dauffenback for providing information about Ruby McKenzie.
regulate breathing; it focuses on timing, which helps to realign the mind. Chanting is simply repeating a short phrase or series of syllables, a long “A- a – men,” over and over. I find this extremely useful when putting together my writing. I walk around the block focusing on a short sentence – “Thank you for everything that you’ve given me.” I try to clear my mind and focus only on my breathing and the rhythm of the words. I feel the rhythm of my feet pounding on the pavement, stress slowly
draining out of my body through my feet and out into the ground. I’m letting go of clutter, making room for clean fresh air. I let my mind and spirit rest on an attitude of gratitude. I chant this way for about a mile. Inevitably, once the rhythm is established, my mind will wander and thoughts and ideas will fall into place. Visit www.Anneadametz.com for more relaxation information. Visit brendashealthplan.blogspot.com or email BrendaZarth@gmail.com with comments.
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June/July • 2016
Nursingmatters
Forum offers veteran information
MILWAUKEE – Marquette University’s Student Veterans Association, Veteran Affairs Nursing Academic Partnership and the Clement J. Zablocki Veterans Affairs Medical Center are co-hosting “Embracing Change from the Soldier to Civilian: Veterans Transition to Accessing Care and Services.” The forum will be held July 25 in the Alumni Memorial Union, 1442 W. Wisconsin Ave.,
1-877-895-3276
Milwaukee. The daylong event will begin with registration at 7:30 a.m. The panelists for this conference are from the VA Medical Center and collaborating community agencies. Panelists will share information about their services and how collaboration is achieved to meet the needs of clients who are veterans. The forum has been developed for all veterans, caregivers, health-care providers, educators,
flex.wisconsin.edu
flex@uwex.edu
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Find out more at
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managers, administrators and students involved in or interested in the care of veterans. Admission to the conference is free, but registration is required. Breakfast and lunch will be provided. Parking is available in the structure located on 16th Street between Wisconsin Avenue and Wells Street. Call 414-288-6195 for more information.
Are you interested in working at a place where you can be part of a team that provides quality care to their residents?
Oak Park Place is now hiring: Oak Park Place is a beautiful senior community that offers a range of care that includes Independent Living, Assisted Living, and Skilled Nursing. We are located on the East Side of Madison and are continually renovating and reinventing to provide the best care possible. We are looking for Registered Nurses to join our strong clinical team and would love to match you with the right position for your skills set. Currently we have opportunities for full time and part time, and would like to work with you to have a strong work life balance. Previous long term care experience is preferred, but not required. Please apply online at
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