Nursing Matters 061517

Nursingmatters June 2017 • Volume 28, Number 6

www.nursingmattersonline.com

INSIDE: Opinion

2

East meets West

3

Voter ID needs changes

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Nurse Leader of Year chosen The Wisconsin Organization of Nurse Executives has selected Jan Bauman, vice-president of patient care and chief nursing officer at Divine Savior Healthcare of Portage, Wisconsin, for its 2017 Nurse Leader of the Year award.

Each spring, the organization honors a Wisconsin nurse leader who has made significant contributions to nursing and nursing leadership, to his or her place of employment and the community.

Bauman has been a member of Wisconsin Organization of Nurse Executives for 10 years and an active member of the organization’s Board of Directors since 2009. She currently is chair of the Wisconsin Organization of Nurse Executives Legislative Committee. The Legislative Committee worked diligently on a specialty license plate recognizing nursing, creating a new funding source for professional development, education and scholarships for nursing leaders in Wisconsin.

Bauman served 29-plus years in the Wisconsin Army National Guard where she received numerous commendations and awards for service, including the Legion of Merit accommodation given for exceptionally meritorious conduct in the performance of outstanding service and achievements.

“She listened without interruption or interpretation, allowing stakeholders to openly share their concerns and opinions, which empowered them to succeed,” said Maj. Michael J. Brandt, MS ED., PhD, Wisconsin Army National

“She listened without interruption or interpretation, allowing stakeholders to openly share their concerns and opinions, which empowered them to succeed.”

Maj. Michael J. Brandt, MS ED., PhD, Wisconsin Army National Guard.

Jan Bauman

Guard. “While most leaders recognize the importance of listening to their people, it seemed as though Col. Bauman had a very unique talent for ‘acute’ listening. That is, maintaining listening while in the midst of ‘battle’ – i.e., she was faced with a persistent information stream, situational crisis and yet was able to listen to ‘the troop.’ That was quite iconoclastic for military culture and reflected the actions of selflessness, courage and determination.”

Georgia Brockway, BSN, RN, director of acute care and the intensive-care unit for Divine Savior Healthcare, said,

“(Bauman is) a great role model, mentor and coach … (She) has an ear to listen; she guides with compassion and integrity.”

Bauman has helped to develop new programs to improve patient care, increasing satisfaction scores by creating programs such as the Patient Experience Team or the X-Team. According to Michael Decker, president and CEO for Divine Savior Healthcare, she was the natural choice for leading the organization’s recent successful enhancement to customer-service standards – Divine Service.

“I’m certain the positive impact she’s had on nursing professionals through her career will radiate through future generations of nurses to come,” he said.

Bauman was recognized during the Wisconsin Organization of Nurse Executives Spring Conference held April 27 in Wisconsin Dells, Wisconsin.

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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 © 2017 Capital Newspapers

Nursingmatters

Florence – oh, so relevant “What cruel mistakes are made by benevolent men and women in matters of business about which they know nothing and think they know a great deal.” – Florence Nightingale When I recently read this in “Notes on Nursing,” my immediate reaction was, “Oh my, this is what is happening in our current national Senate. Twelve white males are devising a plan for health care for the men, women and children of this nation.”

I believe it’s time for Kaye Lillesand every professional nurse in this country to become “mini-Florences.”

We can no longer let a few people protect insurance companies that are financing their campaigns instead of providing health for this nation’s residents. Like Florence we need to speak and make a difference. If we don’t, nursing care – the essence of which is promoting good health and healing – will be a thing of the past.

For years our health-care system has been based on curing illnesses rather than preventing them and promoting good health. It has only been the past 20 to 30

years that the notion of prevention has carried any weight. And then every step has been a fight. Look at the effort it took to mandate that insurance companies pay for mammograms in Wisconsin. One would think the insurance companies would realize that it’s less expensive to do several mammograms than to pay for surgery and other therapies to cure breast cancer. That also does nothing to recognize the impact of the individual’s lost work time on family, and on society as a whole. I have said this before. “A nation is only as healthy as the health of its people.”

Then why, please tell me, do we have 12 males deciding what the health-care system for this country should be. Do any of them have any medical background? Are there any nurses, doctors or health-care administrators? Or will decisions only be made on costs and what is best for the wealthy and healthy? Will we end with the same system we had before the Affordable Care Act? Since 2010 nurses have seen the health benefits of the Affordable Care Act. We can see those results daily in our practices.

We must speak out! The Code of Ethics for Nurses challenges us to be advocates for

our patients and for our profession. I have posted on the NURSINGmatters Facebook page an example of an emergency-room nurse from Waukesha, Wisconsin, speaking at a town hall meeting hosted by U.S. Rep. Jim Sensenbrenner, R-5th, about the impact of repealing the Affordable Care Act. It’s beautiful. Watch the audience reaction and then Sensenbrenner’s. We must speak out in every way we can. Right now we need to use that trust people put in nurses and the nursing profession. Speak, call or write. The written word is powerful.

Keep in mind as you take action that you are saving human lives and the nursing profession. That thought will energize you.

Let those “decision makers” understand the results of their actions.

There is no alternative. We must act. Let me close with another appropriate quote.

This one is from Albert Einstein.

“The world will not be destroyed by those who do evil, but by those who watch without doing anything.”

OPINION

Children’s health in danger Gregory Craig American Nurses Association

The U.S. House of Representatives recklessly passed May 4 the American Health Care Act, by a 217-213 vote. They did so with little transparency, thoughtful debate or meaningful stakeholder input. Crucially, they also passed this bill without even knowing its potential impacts on the ability of Americans to access quality health-care services. Based on an analysis of the previous version of the American Health Care Act, however, this bill would likely result in the loss of health-care coverage for 24 million Americans, potential restrictions for 15 million Americans with pre-existing conditions, and $800 billion-plus in Medicaid funding slashed through 10 years.

According to a report released May 18 by Avalere Health, children would be significantly impacted by the proposed Medicaid changes in the American Health Care Act. Funding for children on Medicaid would be slashed by up to $43 billion through 10 years under a per-capita cap plan, while it would be slashed by up to $78 billion under a block-grant plan. While Medicaid is often discussed in terms of an entitlement and

with a particular focus on the controversial Medicaid expansion, its impact on children’s health care does not receive nearly as much attention.

Children represent the largest group of enrollees covered by Medicaid, and the program covers nearly half of all births in the United States. Medicaid provides crucial health-care services to children and, under Early and Periodic, Screening, Diagnostic, and Treatment requirements, these children cannot be denied necessary care.

This health care – or lack of – impacts the health of the child for the rest of his or her life; a healthy child is more likely to grow into a healthy adult.

As we wait for the American Health Care Act to move to the U.S. Senate for

continued on page 3

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WHAT IF ...

East meets West Brenda Zarth

My nurse and doctor friends complain that alternative and complementary medicine needs to be tested to prove efficacy. They want some double-blind-research studies. I try to explain that because each person is unique and EastBrenda Zarth ern medicine is treating the whole person – and each person requires an individualized plan of care – it’s a mistake to try to put Eastern medicine in a box. Eastern medicine is the art of medicine. How would someone do a double-blind-research study on art?

I wrote about Neurokinetic Therapy this past month. I then tried it and realized it might provide some answers in an attempt to make Eastern Medicine measureable.

I have been having neck pain and stiffness for years, so I went to see John McMahon and had Neurokinetic Therapy myself.

The first thing he did was assess my posture and gait, and then he did muscle testing. He asked me to lie on a massage table.

I lifted my leg as high as I could toward the ceiling, and then he pressed on a pressure point. My leg freely went 18 inches further!

He tested several more pressure points, and my muscles responded variably with increased movement, or weakness, or stayed the same. I had assumed the stiffness I had been feeling in my legs and back was due to old age and lack of activity. So I was surprised to feel the fluid movement return. After testing several muscles and watching movement patterns, he determined my hips were frozen and my jaw was what we needed to work on.

I know that sounds crazy, but it makes sense when looking at the “Tom Myers Anatomy Trains” posters all over his office walls. On the posters are exposed muscles connecting all over the front and back of

Craig

continued from page 2 consideration, the American Nurses Association encourages all 100 senators to consider the stakes of this bill for the health of our nation’s children. Access to quality health care for children not only ensures that they are healthy in the here and now, but also ensures that we are raising a healthy and productive

the human body, in connected layers and series. On top of muscles, the human body is covered with connective tissue, nerves and skin. All body parts are in constant communication, much like the insides of an orange. The segments of an orange are separate, but connected together with membrane and white parts. Pulling on any one part can apply pressure and communicate with all the other parts.

Again through muscle testing, McMahon defined causative muscles to innervate and communicate with the rest of my body.

He applied pressure to two sets of jaw muscles and I could feel my body unwind through involuntary movements of my neck. During 90 minutes, with several trips off the table to stretch and rest, my body felt like it unraveled.

When I was finished I felt less stiff. My hips moved freely, my pelvis was looser, my lungs felt like they had more expansion, my spine felt stronger but also more flexible, and I felt straighter and taller. My neck remains stiff; my neck muscles are exhausted from activity. It will take time to continue to unravel what I traced back to a childhood accident.

I can see Neurokinetic Therapy as a communications bridge that provides a visual to help appreciate the importance of Eastern medicine and help to understand how and why it works. Chiropractic, Acupuncture, reflexology, craniosacral therapy and naturopathic medicine are all

continued on page 4

generation of Americans who are able to lead productive lives to the best of their abilities. The American Nurses Association also urges the Senate to reject the flawed American Health Care Act – which flies in the face of our stated health-care-reform principles – and to undertake a deliberative, thoughtful and transparent process to produce a piece of legislation that ensures quality healthcare access to all Americans.

All body parts are in constant communication, much like the insides of an orange. The segments of an orange are separate, but connected together with membrane and white parts.

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June • 2017

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OPINION

Remove college-ID voter restrictions Common Cause in Wisconsin

Wisconsin experienced its first presidential election this past November, in which voters were required to present photo identification at the polls – a requirement put into place to address the nonexistent problem of “voter fraud.”

There is little doubt that Wisconsin’s extreme and restrictive voter-photo-ID law disenfranchised tens, if not hundreds, of thousands of eligible voters who did not have one of the few forms of ID acceptable for voting, such as a Wisconsin driver license or a state ID card. Among those most negatively impacted by the requirement were seniors, the poor, citizens of color – and college students, primarily students from out of state.

A college-student-ID card is listed as an acceptable ID for voting. However a student ID can only be used as a voter ID if it was issued by a Wisconsin-accredited institution and the ID includes a photo of the student, a signature, the date it was issued and the date it expires. Further, the student ID cannot expire more than two years after the date it was issued. But the ID can be expired, thanks to a federal-court ruling in late July 2016.

Unlike any other form of ID used for voting, a student ID requires additional documentation in order to be used as a voter ID. Students must also bring, or show electronically, proof of current enrollment such as a tuition statement.

Confused? Concerned? It’s worse.

The majority of student IDs issued by Wisconsin colleges and universities do not meet the criteria for use as a voter ID. According to research conducted by Common Cause in Wisconsin during the past year, standard student IDS could only be used as voter IDs from three of the University of Wisconsin’s 13 four-year schools, at none of the UW-System’s 13 two-year schools and at only seven of Wisconsin’s 23 private colleges.

Separate “Voter ID cards” are available upon request at the 23 UW-System schools, and at nine of the 16 private colleges whose standard student IDs cannot be used as voter IDs – but students must

Zarth

continued from page 3 working on a similar understanding.

That is that one can’t do something to one part of the body without the rest of the body potentially being affected by it. Everything is connected and

CARRIE ANTLFINGER, ASSOCIATED PRESS

Catelin Tindall tried to vote in November but had to cast a provisional ballot because she didn’t have a valid Wisconsin ID. Her student ID from the Milwaukee Institute of Art and Design didn’t have an expiration date or say when it was issued, so she was required to cast a provisional ballot and was unable to return to the county clerk’s office in time to have her vote count.

take action in order to get one of those college-issued voter-ID cards.

Notice a pattern here? There’s more.

When other IDs are presented as voter IDs, poll workers are instructed to only look for a voter’s name, photo and the ID’s expiration date – if one is required. Conversely, when examining student IDs, poll workers must also check for the criteria listed above – including a signature. Note that some of the other acceptable IDs do not even include a signature – such as some Tribal ID cards – and those that have

one do not need the signature’s appearance on the ID verified when voting.

Bottom line, as a result of Wisconsin’s strict voter ID law college students are treated differently, facing unnecessary barriers to voting. This deliberate disenfranchisement is wrong and must be addressed. We should be encouraging civic participation by young voters, not preventing it.

Recently the U.S. Supreme Court declined to hear an appeal of a federal-court decision overturning North

Carolina’s restrictive voter-ID law – sending a strong message nationwide that such voter-suppression measures are unacceptable.

Common Cause in Wisconsin calls on the Wisconsin State Legislature to address the obvious excessive burden Wisconsin’s voter-photo-ID law places on college and university students, by removing the unnecessary restrictions placed on those who use student IDs as voter IDs. A voter photo ID is intended to prove who the voter is. That’s it.

communicating. The level of effect on the body when an event occurs may seem insignificant, but it may be the start of a chain of events.

In second-grade I fell and injured my neck. The initial pain resolved, but there was always extra tension. That tension during time gained in importance, and

other events exacerbated the injury to finally create a problem that was not easily ignored. It takes time to unravel what may have occurred during years. But the end result can be amazing and permanent.

I love that Eastern medicine has no negative side effects. When the body unwinds itself, there are no mistakes and no new

problems. McMahon could have used tools to measure the increased degrees of flexion and extension I was capable of during muscle testing. I hope more therapists learn this fascinating dramatic therapy.

Email BrendaZarth@gmail.com or visit brendashealthplan.blogspot.com with comments or questions.

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June • 2017

Beauty – search for ideal Dr. Mary Ellen Wurzbach

In Greek and Roman times, Socrates, Plato and Aristotle tried to define several concepts. Plato’s came to be known as Platonic Ideals. One of the ideas he tried to define was beauty.

An ephemeral concept, it’s often said to be in the eye Mary Ellen of the beholder. Everyone Wurzbach thinks about or feels beauty differently.

I agree with Plato that it’s possible to have an ideal of beauty. I may or may not agree with him that this standard for beauty or essential sense of beauty is universal. He searched for universal beauty and did not believe he had found it, but thought that it must exist.

I believe I have found that ideal. Not physical beauty as in a person, but a skill that all would say is beautiful. It’s often said that some mathematical equations have elegance – one form of beauty. Some artwork, clothing or jewelry can be said to be beautiful, and some music or writing can be said to be remarkably beautiful.

My own ideals of beauty are symbolized by nurses and nursing. For some ineffable reason some threshold of excellence seems to be exceeded. The feeling evoked is both affective and cognitive – an appreciation of the skill necessary to provide care and kindness.

At the moment one hears, reads or sees ideal beauty, some acknowledgment is necessary that one has experienced something so unique that no other experience can totally compare. One feels compelled to acknowledge the true and essential

excellence of what one is hearing or seeing.

Beauty makes one feel as though something “just right” has happened.

Something that has so reached a height, and approximated “rightness,” to such a high degree, that one is startled into silent awe. It’s so “solidly right” that the feeling is almost inexpressible. One believes that all persons viewing or hearing such artistic accomplishment would agree.

What is “rightness?” In music, “rightness” is hitting the perfect chord or tone – so pure as to be indistinguishable from perfect sound. It might be the fingerings – manual dexterity as well as tonal quality. In writing, beauty is saying exactly what one wants to say or hopes another will say in some elegant, profound or illustrative way.

The spoken word, too, has elegance.

Some, such as Abraham Lincoln’s Gettysburg Address, combine the spoken word with the written. Others, such as the saying on the Statue of Liberty, claim attention for their poignancy. Still others, such as our Preamble to the Constitution of the United States or Patrick Henry’s “Give Me Liberty or Give Me Death” speech, capture the moral imagination.

Some essential quality of sound and sight brings beauty to life – brings a tone, a word, a phrase or a thought to life. Nurses and nursing attain this essential ideal called beauty. In caregiving, most meet an ideal and set a standard.

One thinks of art and beauty as interchangeable. Typically art is thought of as a painting, but it may be a song, a composition, or a design of jewelry or clothing. It may also be a relationship that is just the epitome of “rightness” – someone who so closely epitomizes a role that he or she

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Ideals of beauty can be symbolized by nurses and nursing.

meets the high ideal of a “beautiful person.” Nurses meet this ideal.

I know beauty is indefinable to some extent. Plato was right; it’s an unattainable goal. But every once in a while in life, speech or writing, one experiences a moment when all is well and sheer beauty is profoundly felt by the observer.

One would expect beauty to be spontaneous, and this may be so, but to some extent it’s a goal to be achieved through hard work and great effort. Beauty is the gift we give each other. It’s the beauty of a relationship – the beauty of a piece of music, an artwork, an article or book. But some beauty, although born of hard work

and effort, in the end is spontaneous – an episode of clear and pure effortless – but effortful – improvisation. And that is nursing care.

Beauty is an acknowledgment of life or of another person or achievement.

Beauty is ephemeral. Beauty is pure simple loveliness, whether it occurs naturally or as a result of a learned skill, whether spontaneous or thoughtful. Beauty is an acknowledgment of life and spirit. It’s an affirmation of the “rightness” of certain moments. This acknowledgment is recognizing and celebrating the “goodness” of another, of life, or, as in our case, of nursing.

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June • 2017

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June • 2017

Nurse’s last wish fulfilled PHUONG LE, Associated Press

SEATTLE (AP) – Nancy Zingheim barely knew Rita Poe when Poe approached her office at a Washington-state RV park. Poe, a shy registered nurse, had a request for the RV park business manager. Could Zingheim help her with her will?

Weeks later, Poe, 66, died of colorectal cancer. In her will, she left nearly $800,000 to a dozen national wildlife refuges and parks, mostly in the American West. She named Zingheim the executor. Zingheim knew little about Poe, who had moved to the Evergreen Coho SKP RV Park in the small town of Chimacum just five months earlier. She knew even less about national wildlife refuges.

That was in 2015. This year Zingheim embarked on a 4,000-mile road trip to learn more about the woman who lived in an Airstream trailer with her dog and cat – and to learn more about the wild places that captivated her.

“I wanted to see what they were,” said Zingheim, 62. “I decided that I wasn’t going to suddenly write checks to places at face value. I wanted to do my due diligence and find out what they needed.”

Through nine days she drove Poe’s Ford pickup truck in a loop of the American West. She visited six national wildlife refuges in California, Idaho, Oregon and Washington – part of a vast network of reserves across the United States where wild lands are protected for wildlife.

President Theodore Roosevelt established the first refuge in 1903 at Florida’s Pelican Island. The U.S. Fish and Wildlife Service manages more than 560 such refuges. From wetlands in Florida to tropical forests in Hawaii, the lands are set aside for migratory birds, alligators, bears and countless other creatures. There’s at least one in each state, and a majority are open to the public for free.

At each stop, Zingheim asked around.

“Do you know Rita?” No one did. One person recalled Poe’s 27-foot Airstream trailer but little else.

“To this day, I don’t think any of us knew a lot about her,” Zingheim said.

Zingheim also took a tour of each refuge. She asked refuge managers what they needed and wanted. And she tried to imagine how Poe connected to those places.

“The reserves, they’re quiet places. I could see Rita there,” she said.

In time, bits of Poe emerged. Poe grew up in Southern California, worked as a nurse at a suburban Los Angeles hospital and spent time in Texas.

Terry Poe said he last saw his sister in 2007. After their parents died, leaving them money, he said, she bought a trailer and traveled around the western U.S. to various

ELAINE THOMPSON/AP

Nancy Zingheim smiles as she sits in a truck given to her in Chimacum, Washington. Zingheim barely knew Rita Poe when Poe approached her office at an RV park in Washington state, asking for help with her will.

AP

Rita Poe’s 1981 driver’s license — when Poe died of cancer, she left nearly $800,000 to a dozen national wildlife refuges and parks, mostly in the American West. She put a woman she barely knew, Nancy Zingheim, in charge of carrying out her wishes.

refuges and national parks.

“She enjoyed nature and being out in nature,” he said in a telephone interview from Southern California.

Rita Poe owned several high-end cameras. She was a birder. On her computer, Zingheim found stunning photographs of birds, bears, ocelots and bobcats.

RITA POE

This 2013 photo provided by the estate of Rita Poe shows her dog, Iggy, and cat, Sunshine, her traveling companions.

There were trips to New Mexico, Arizona and Canada.

Zingheim said in the process of carrying out Poe’s wishes, she felt she’d been granted her own bequest. And she’s grateful for it.

“I saw things that I would never have seen,” Zingheim said. “I didn’t know a

national wildlife reserve even existed. I don’t think a lot of people out there know about them. They should. They’re wonderful places.”

Brian Wehausen gave Zingheim a tour of the Camas National Wildlife Refuge’s high-desert landscape and wetlands when

continued on page 8

June • 2017

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RITA POE

This 2013 photo provided by the estate of Rita Poe shows black-tailed prairie dogs.

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ELAINE THOMPSON/AP

Nancy Zingheim displays a photo of an American goldfinch taken by Rita Poe, as Zingheim sits in her RV office in Chimacum, Washington.

Poe

continued from page 7 she arrived this past spring. Poe had taken photographs of bald eagles and moose on a visit to the southeast-Idaho refuge.

“Our refuge is fairly small. It would seem to fit a personality like Rita’s,” said Wehausen, refuge manager. “She could come out here, bird, photograph, and she doesn’t have to see a lot of other people.”

Back on Washington’s Olympic Peninsula after her trip, Zingheim sat down this past month and wrote checks. They included money to support Camas, the Merced National Wildlife Refuge in California, Little Pend Oreille National Wildlife Refuge in Washington, Malheur National Wildlife Refuge in Oregon and Bear River Migratory Bird Refuge in Utah.

She also sent money to Yellowstone National Park, two state parks and a Texas birding center.

“There’s a spiritual connection that people feel about these places. They

have a lot of meaning to a lot of people,” said Tracy Casselman, project leader for the wildlife-refuge complex that includes Camas.

Casselman said Poe’s gift will ensure more people enjoy such places.

With each check, Zingheim wrote a letter directing how some money should be used.

“I think she would have agreed with me, I really do,” said Zingheim, who has since adopted Poe’s dog, Iggy.

Steve Gillard, the Washington attorney who handled Poe’s will, said it’s unusual for people to name someone they barely know to distribute their estate.

“But it’s very unusual for a person like Nancy to take on that responsibility,” he said. “She’s a very good human being.”

Zingheim also fulfilled another of Poe’s wishes. She scattered the nature lover’s ashes in a wooded area surrounded

by Washington’s snow-capped Olympic Mountains.

She said, “Every time I drive by, I say ‘Hi, Rita.’”

718 Jupiter Drive, Madison, WI 53718 RITA POE

This 2013 photo provided by the estate of Rita Poe shows her photo of a great horned owl.