Nursingmatters June/July 2014
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Volume 25, Number 6-7
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InsIde:
Murray, associate dean for academic affairs retires from UW sOn
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Hats of Hope program combats infant mortality in Tanzania
4
nurse residencies come to long-term care nurses
7
signe Cooper: Jane Taylor’s life one of travel, adventure
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Porth receives Honorary degree from Columbia College of nursing Columbia College of Nursing (CCON) celebrated its 110th Pinning Ceremony in May. During the ceremony, Dr. Jill Winters, President and Dean of Columbia College of Nursing, presented Dr. Carol Mattson Porth with an honorary Doctor of Humane Letters for her outstanding contributions to the welfare and development of nursing science and the practice of nursing. It was truly an exciting and memorable celebration for all who attended this event. The honorary degree is conferred as a way of honoring a distinguished visitor’s contributions to a specific field, or to society in general. The practice dates back to the Middle Ages, when a conferring university saw fit to grant exemption from usual statutory requirements for award of a degree. Dr. Porth is one such person. Dr. Porth began her career as a nursing educator at the University of Wisconsin-Milwaukee in 1968.
Dr. Carol Porth (right) receives her doctorate from Dr. Jill Winters. PHOTO BY JOHN VOELZ
She has served on the faculty there, and was promoted from Instructor to Assistant, Associate, and finally Full Professor in 1990. Dr. Porth was granted Professor Emeritus status in 1997, but don’t think for a moment that she had completed her career!
Students at the Columbia College of Nursing (CCON) celebrate their graduation. PHOTO BY JOHN VOELZ
She has been the recipient of many awards, including the Milwaukee District Nurses’ Association Education Award, Marquette University College of Nursing Outstanding Alumni Award, and the University of Wisconsin-Milwaukee School of Nursing Person of Influence Award, among others. Dr. Porth was honored by CCON with this symbolic degree as she exemplifies all the attributes associated with knowing, doing, and being a nurse, the philosophical base of the curriculum at CCON. Knowing is the process of acquiring information, skills and abilities, attitudes and dispositions that characterize the professional nurse. Doing is the synthesis of knowing and being into practice. Being is the profoundly personal and often intense process of developing one’s identify as self and nurse as inextricably bound in continued on page 5
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EDITORIAL
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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. %VERY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 Bonnie Allbaugh, RN, MSN Madison, WI Cathy Andrews, Ph.D., RN Associate Professor (Retired) Edgewood College, Madison, WI Kristin Baird, RN, BSN, MSH President "AIRD#ONSULTING )NC &ORT!TKINSON 7) Joyce Berning, BSN Mineral Point, WI Vivien DeBack, RN, Ph.D. Nurse Consultant Empowering Change, Greenfield, WI Mary Greeneway, BSN, RN-BC Clinical Education Coordinator Aurora Medical Center, Manitowoc County Mary LaBelle, RN Staff Nurse Froedtert Memorial Lutheran Hospital -ILWAUKEE 7) Susan Lanphier Marsh, MS, RN Director, Midwestern Performance Assessment Center, Madison, WI Claire Meisenheimer, RN, Ph.D. 0ROFESSOR 57 /SHKOSH#OLLEGEOF.URSING /SHKOSH 7) Steve Ohly, ANP Community Health Program Manager 3T ,UKES-ADISON3TREET/UTREACH#LINIC -ILWAUKEE 7) 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 Š 2014 Capital Newspapers
Nursingmatters
2020 AD: Compare and Contrast
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REPRINT FROM 1993
“Example is not the main thing in influencing others, it is the only thing.� – Einstein EDITOR’S NOTE: Recently, while searching for Signe Cooper articles, I came across an editorial I wrote in 1993, 21 years ago. I wanted to share it with you and would appreciate your comments on how things might look in 2040. In our last issue we asked our contributing authors to add a look into the future on whatever topic they Kaye Lillesand were discussing. I thought I should set an example through this editorial. The year is 2020 AD. The University of Wisconsin still has a very progressive school of nursing. Currently students take basic courses and then choose from three tracks to complete their program. The Primary Track is geared to educate nurses to function outside the realm of direct patient care. The Secondary Track is geared to the many areas involved in community health. The Tertiary Track deals with patients with acute illnesses and long term care needs. A BSN plus an internship is the entry level into the practice of professional nursing. The June class of 2020 is finishing up their course work and are about to start their internships. Here is what a few of them are doing.
Following the Primary Track: S.L. has a minor in Political Science along with her nursing degree. She will be interning as a nurse lobbyist with a large lobbying
firm in Geneva, Switzerland. J.K. wants to become a forensic nurse. She is doing her internship with the Los Angeles District Attorney’s office. L.M. is going to be researching health in space. She will be getting her PhD in research after her internship with the Space Agency in Houston, Texas. M.R. has a minor in Transpersonal Psychology. She is interning with an architectural firm specializing in community planning. She plans to do work in the area of designing communities which create the greatest potential for physical, emotional and spiritual well-being of the community and of all the individuals within it.
Following the Secondary Track: T.C. majored in Public Health. He will be interning at Combined Nursing Services in the Eau Claire/ City/County Health Department in Eau Claire, Wisconsin. The department is charged with improving the health of the community. He will be working in an elementary school where he will be teaching wellness (i.e. chronic disease prevention, accident and injury prevention, coping mechanisms, nutrition, etc.) to students from kindergarten to eighth grade. K.S. wants to specialize in Adolescent Health. She is interning at a high school nursing center in Miami, Florida. M.H. is interning at the Boston Women’s Wellness Sphere. She will be in the New Life Sector where eggs are fertilized and nurtured in an artificial uterus. She will be working with the fetuses and couples who are about to realize a child with this method.
And following the Tertiary Track: W.P. is doing his internship at Rush Presbyterian St Luke’s in Chicago on a “Dealing with a Change in Body Image� unit. He Plans to go on for his Masters and become a Clinical Nurse Specialist in this field. D.P. has his internship at a specialty hospital dealing with the latest disease of the 21st Century, Altered Sensory Brain Wave Syndrome (ASBWS). He plans to work with these patients who have great distortions in their sensory abilities, probably due to exposure to computers. G.V. intends to be a Clinical Nurse Specialist for centenarians, persons 100 years old or greater. She is interning at a nursing home exclusively for centenarians in Montreal, Canada. These are just a few of the exciting careers that could be created by nurses in the 21st Century. OR the future could take a different course. Last month I wrote that if we didn’t create a vision for ourselves someone else would. This month when I opened my American Journal of Nursing (November 1993) I found an article which demonstrated this idea. It is entitled “The Newest Layoff Strategy Forcing Nurses to Compete to Keep Their Jobs� (p. 86). The article describes a process used to “reorganize’ a hospital. RN positions were reevaluated, shifting some benefitted positions to per diem without benefits. All positions were then posted and nurses were required to “bid� for their jobs. New qualifications were required for many positions. continued on page 3
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Associate dean for academic affairs retires from UW–Madison SON Mary Ellen Murray, reimbursement systems, Ph.D., RN, associate dean costs of care, patients’ for academic affairs and health insurance plans professor of nursing, will – it is all part of fiscal retire in June of 2014, responsibility.” after 16 years as a faculty “Nurses are the largmember of the University est sector of employees of Wisconsin–Madison in the health care indusSchool of Nursing. try,” she adds. “They Performance measures have the potential to – quantifiable expresdecrease health care Mary Ellen Murray sions of efficiency and costs without comproMEDIA SOLUTIONS effectiveness – have mising patient care.” driven Murray’s research Murray played a key centered on the microeconomics role in the development of the UW– of health care. Mindful of the trigMadison School of Nursing Western gers in health care reform, specifiCampus, a partnership between the cally quality, cost and sustainability, school and Gundersen Lutheran Murray sought to quantify fiscal Health Systems in La Crosse, and clinical outcomes in patient care Wisconsin. As director of the that inform health care systems’ Western Campus for Nursing from processes and policies. Her program 2002 to 2006, Murray applied her of research, which included studies brand of management strategy to the that cross continuum-of-care setprogram, which produced successful tings (i.e., inpatient, ambulatory, growth. When the program ended and home health services), produced in 2009, the School of Nursing had coordinated patient care strategies met its goals, graduating 133 baccathat demonstrated cost-benefit. laureate-prepared students. “In a reformed health care sys“The best part of the Western tem,” Murray says, “nurses have Campus initiative was how it a responsibility to the patient to brought people together,” Murray use the most cost-efficient comsays. “It was a teamwork experience bination of resources to maximize with cost-effective use of resources health benefit. Understanding and sustaining benefit.”
2020 AD continued from page 2
The article went on to say, “Morale wasn’t helped by a bulletin circulated by management. ‘When the winds of change hit your organization, here’s the bottom line: Resisting does more harm than good. To begin with you could get nailed for being oppositional. Someone may accuse you of causing trouble, getting in the way of progress; that easily damages your career...Besides, you’re going to lose the battle anyway; even if you do win a skirmish now and then, you’re going to lose the war. Instead of trying to hang on to the past, grab hold
of the future.’” Is this the kind of future we want to “grab hold of?” Is this the kind of future we want to create for ourselves? By allowing this kind to happen, we are creating this kind of future as opposed to the kind in the first part of this editorial. Compare and contrast. With hard work and commitment we can create the future we want. If we choose to do nothing, someone else will create it for us and it could be pretty grim. It is a lot easier to work hard for something you believe in than it is to work hard in an environment that you don’t believe in. Get involved in creating that future. Let us not just “grab hold of ” one that someone else has created for us.Q
In 2007, Murray took on the role of associate dean for academic affairs, putting systems in place that worked for people – a role, she said, that felt very natural. In this position, Murray shepherded web-based solutions in support of the research, education, and administrative needs of the school. She established strategic goals to enhance the use of learning technologies in the school’s research, teaching, and scholarship efforts. As co- or principal investigator on numerous Robert Wood Johnson Foundation grants, she evaluated innovations in nursing education that increased the number of nurse educators, thereby, shoring up numbers within the nursing workforce. She also explored ways to leverage quality improvement of instruction by applying QSEN (Quality and Safety Education for Nurses) Institute teaching strategies to curriculum
design. Murray maintained a strong alliance with the Wisconsin Center for Nursing. She produced two policy papers adapted from data analysis that she led for the Wisconsin Center for Nursing (WCN) on the current state of the nursing work force in Wisconsin. Entitled the Wisconsin Registered Nurse Survey 2010 Report and the Wisconsin Registered Nurse Survey 2012 Report, both will likely direct future strategies for the state’s RN workforce within the larger context of health care reform. While performance measures informed Murray’s successful tenure in research, scholarship, and education at the School of Nursing, her vast and sustaining contributions to the School of Nursing are, undisputedly, immeasurable. –Kathleen Corbett Freimuth
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Hats of Hope program combats infant mortality in Tanzania By Karen Klemp, Hope 2 Others Founder and RN, BSN, MA and Rachel Wittrock, Hope 2 Others Public Relations Director
Last month’s Nursing Matters featured Hope 2 Others’ Helping Babies Breathe program. This month’s segment shares how the Sun Prairiebased non-profit has partnered with churches, schools and civic organizations to ensure a brighter future for Tanzania’s most vulnerable population: newborn babies. A warm and nurturing environment is vital to a child’s survival. The mother-child bond and physical contact is necessary when a baby enters the world and opens its eyes for the first time. Physical contact immediately after delivery not only helps establish a healthy bond between mother and child, it also helps keep the baby warm. As a NICU nurse at Madison Meriter Hospital for more than 30 years, Hope 2 Others Founder Karen Klemp knows how important it is that newborns are kept warm. After a baby is born, the little bundle of joy is placed next to his or her mother, skin-to-skin. A baby hat and blanket ensure the newborn is surrounded in warmth. While making sure a baby is swaddled and warm immediately after birth is common practice in the United States, the importance of it is just being realized in Tanzania. During a recent mission trip to Tanzania, Karen Klemp and nurse midwife Nancy Comello hosted a Helping Babies Breathe workshop at the Youth With a Mission (YWAM) Uzima Mission Clinic in the Mwandege area of Dar es Salaam. “We teach skin-to-skin. If the baby is healthy and breathing, you can do basic stimulation with the mom. When it (the baby) is whisked off unnecessarily, there is a lot of loss,” Karen Klemp said. “If you keep skin-to-skin and place a little hat to keep their heat in, that makes a huge difference in the outcomes. If a baby gets hypothermic, their blood sugar drops, they can have respiratory problems and it can snowball
A newborn care kit from Hope 2 Others.
A Tanzanian woman practices newborn resuscitation techniques during a Helping Babies Breathe seminar in Dar es Salaam this past January.
into bigger things.” While there, Karen heard about a new law that was passed in Tanzania. The law requires babies born in medical centers, hospitals and clinics to have a blanket, hat and booties before being discharged. Why the law? According to Save the Children, 7 million children die before the age of 5 every year, mostly from preventable causes. According to statistics provided by the World Health Organization, nearly 40 percent of all under-5 child deaths are among newborn infants, babies in their first 28 days of life or the neonatal period. When you think of Africa, what images pop into your head? Tropical rainforests? Deserts? But during the rainy and winter season, temperatures can drop. In early May, temperatures dropped to 63 degrees with a 61 dew point in Arusha, Tanzania. “People don’t think countries along the equator are as cool, but when you are in the mountains and at altitude and in the rainy season, it gets very chilly and it does not take much for a baby to lose its
heat,” Hope 2 Others founder Karen Klemp said. According to Save the Children, “it takes just two minutes for a wet, newborn baby to lose a dangerous two degrees in body temperature. Most of this vital heat is lost through soft spots on a baby’s head.” The law addresses a major concern for newborns in Tanzania: infant death from hypothermia during the first 10 days of life. After the Klemps returned from Tanzania, they discussed the new law with friend and Madison Meriter Hospital neonatologist Dr. Julie Kessel and her 9-year-old daughter, Rachel. After hearing the news, Rachel wanted to help, and decided to ask some of her elementary school friends to help her collect items for Tanzania’s most vulnerable population. It was from that simple desire to help that the idea to create newborn care kits was borne. Called Hats for Hope, the kits include a knit hat, blanket and booties, two onesies/undershirts, two sleepers, two cloth diapers, a bar of baby soap
and a newborn teething toy, all in a 2.5-gallon Ziplock bag. The Klemps shared the idea to create and ship newborn care kits with members of the Hope 2 Others Advisory Board, and before they knew it, the idea had spread, with multiple groups wanting to help. The Wisconsin Craft Market donated 19 skeins of yarn to knit the booties and hats. “We are just thrilled to be able to help out in that way,” Paul Zarnikow of Wisconsin Craft Market said, adding that he has the easy part. “The people that come in, whatever creative outlet they choose, I am amazed at the time they put in.” Misti International Inc. donated more than 100 skeins of its pre-production baby alpaca yarn. The preproduction yarn is good to knit and crochet with, but not sold in stores. As a result, Misti International Inc. owners Jose Miguel Paz and Lisa Murray-Paz recently approved giving the pre-production yarn to charities, and Hope 2 Others made the list. But yarn does not weave itself into blankets, booties and hats. That job has been enthusiastically undertaken by a number of crafters, including RSVP of Dane County, whose members have committed to making 200 each of booties, blankets and hats by the fall; the Winona State Knitters; Edgerton United Methodist Church members; continued on page 5
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Hats of Hope continued from page 4
and retired medical residents at Oakwood Village Prairie Ridge. The Kids Express Learning Center in Middleton has also embraced the program and held a drive to collect items for the newborn care kits from May 5 to 30 at the school. The first kits will be taken to Tanzania during this summer’s mission trip in June and July and distributed to Uzima Mission Clinic in Dar es Salaam and the Ngarenaro Health Center in Arusha. Additional kits will be shipped in the fall. “I think it is a good way to bring awareness of things on a global level,” Karen Klemp said. “They are things that we take for granted that are simple, but it can make a
Porth continued from page 1
multiple contexts, including culture, learning, and experience. Dr. Porth has been a distinguished nursing leader and role model for all nurses throughout her career. Dr. Porth has been an outstanding educator, touching lives of countless nursing students. She has published multiple editions of two pathophysiology textbooks that have been translated into many different languages, and her name is synonymous with pathophysiology. In addition, Dr. Porth has provided many opportunities for her colleagues and former students to publish chapters in her books, helping to launch and/or advance their professional careers. To show how her work has personally touched our lives, Dr. Winters asked anyone that had read one of Dr. Porth’s books to please stand during the Pinning Ceremony. The majority of the audience stood in recognition of Dr Porth’s significant contribution to nursing and her lifelong work. CCON is the longest-standing nursing college in the State of Wisconsin, with more than 100 years of rich history in nursing education, dating back to 1901. CCON provides BSN students with state of the art technologies and instruction in the art and science of nursing to
Page 5 huge impact on the life and death of an infant that does not have these simple resources.”Q To learn more about Hope 2 Others ministries or find out about how you can get involved, visit www. bringinghope2others.com, email Hope 2 Others Founders Karen and Rick Klemp at krklemp@gmail.com, or contact Public Relations Director Rachel Wittrock at hope2others.wittrockra@gmail.com. AT RIGHT: Dr. Julie Kessel’s daughter, Rachel (left), displays one of the newborn care kits she put together for Hope 2 Others. After hearing Hope 2 Others Founder Karen Klemp (right) talk about a new law passed in Tanzania requiring all babies born in medical centers, hospitals and clinics to have a hat, booties and blanket, Rachel asked some of her friend to help her collect items to create the care kits.
prepare them for the complexities and challenges of professional nursing and the health care field. CCON is proud to report a 100 percent NCLEX pass rate for the December 2013 graduates. CCON is an upper division program, whereby prospective BSN students are admitted to CCON after transferring 62 credits of prerequisites, where they complete the final two years of nursing education. The College independently grants a Bachelor of Science of Nursing (BSN) and is approved by the Wisconsin State Board of Nursing, and accredited by the Higher Learning Commission (HLC) and the Commission of the North Central Association of Colleges and Schools and the Commission on Collegiate Nursing Education (CCNE). CCON also offers a Master of Science in Nursing (MSN) degree with a focus on the Clinical Nurse Leader (CNL), designed for the working professional RN to complete in less than 17 months.Q Linda C. Baker, Ph.D., RN, Associate Professor CCON, Glendale, earned her BSN and Ph.D. from University of WisconsinMilwaukee. Margaret (Meg) Brethauer, MSN RN-BC, Clinical Assistant Professor CCON, earned her Master’s in Nursing from Cardinal Stritch University.
Assistant Professor of Nursing The Henry Predolin School of Nursing at Edgewood College announces the opening for two full-time tenure track faculty positions beginning with the academic year 2014-2015. Responsibilities include teaching at the undergraduate and graduate (MSN and DNP) levels. Graduate concentrations include Nursing Administration and Leadership. Qualifications: • Earned PhD in Nursing (preferred), or doctorate in related field with a Master’s degree in Nursing; DNP may be considered • Eligible for RN licensure in the State of Wisconsin • Evidence of teaching, scholarly and community services potential • Knowledge and skills in contemporary practice issues related to the AACN Essentials • Demonstrated commitment to promoting diversity, inclusion, and multicultural competence To Apply: Send a letter of application, resume, and references to: Edgewood College Human Resources – APN1 1000 Edgewood College Drive Madison, WI 53711 www.edgewood.edu E-mail: humanresources@edgewood.edu Equal Opportunity Employer
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Nursingmatters
The Wisconsin Nursing Workforce: increase capacity of BSN completion programs IOM Report Key Message
Nurses should achieve higher levels of education and training through an improved education system that promotes seamless academic progression toward 80 percent of workforce with BSNs and double the number of nurses at the doctoral level by 2020. Welcome to the fifth in a series of articles presented by the Wisconsin Center for Nursing (WCN) from its report, “The Wisconsin Nursing Workforce: Status and Recommendations.” Each article presents a unique Wisconsin nursing work force issue, along with recommendations and strategies to address it. In addition, the relevant key message from the IOM Future of Nursing Report is identified. Consider actions your organization can take to address and solve these issues in Wisconsin to avoid a future nursing work force shortage.
Wisconsin Issue #4: Currently 53.5 percent of nurses working in Wisconsin have a BSN, or higher degree. Wisconsin needs to increase educational capacity of BSN completion programs to support seamless academic progression options to meet the goal of 80 percent BSN by 2020.
Recommendation: sªª4RIPLEªTHEªNUMBERªOFª!$.ªNURSESªCOMPLETing a BSN or higher degree annually by 2020. sªª2EMOVEªIDENTIFIEDªBARRIERSªTOªACADEMICª progression: funding, access and time constraints. sªª!SSISTª!$.ªGRADUATESªFROMªUNDERREPREsented populations to achieve BSN or higher degree education.
Strategies: 1. Implement dual track enrollment between technical colleges and 4-year institutions to facilitate students’ ability to attain a BSN, or higher degree. 2. Seek state funding for the expansion of face-to-face and online BSN completion programs. 3. Expand shared curriculum and competencies models and accelerated curriculum options. 4. Evaluate and implement innovative push-
pull models, with established partnerships between ADN and BSN programs to facilitate students furthering their education, including specific models to identify and support students from underrepresented populations. 5. Develop a one-credit professional course offered during the ADN program to include content on career pathways in nursing and academic requirements. 6. Assess educational status of nursing staff by health care systems by 2014, develop and implement plans by December 2015, and monitor achievement of degree completion progress annually. 7. Foster innovative strategic regional partnerships between schools and healthcare systems to advance nursing education opportunities, including increased tuition support and flex time options. 8. Seek private dollars from foundations, corporations and individuals for scholarships for undergraduate and graduate education to accelerate academic progression. 9. Continue seamless academic progression and support for LPNs to achieve ADN or BSN degree. Wisconsin’s nursing schools are the critical suppliers of the nursing work force and prepare excellent nurses. In 2012, 3,006 graduating nurses passed the NCLEX®RN exam in Wisconsin, with a 91.8 percent first time-pass rate, higher than the national rate. Graduates of Wisconsin nursing programs tend to stay to work in Wisconsin; more than 85 percent of the nurses who are educated in Wisconsin schools of nursing are working in Wisconsin. The IOM recommendation of 80 percent BSN by 2020 is based on evidence that shows improved outcomes and decreased mortality for patients along with the knowledge base that is needed to meet the demands of changing patient needs. Educational level of nurses
is a key factor in patient safety and quality outcomes. The BSN nurse is also able to practice in a variety of settings with a broader scope and knowledge in leadership, case management and health promotion as roles for nurses expand. If Wisconsin is going to meet 80 percent by 2020, this translates to a current unmet demand for BSN completion programs for nearly 20,000 nurses. Nursing programs at all WTCS colleges are working to promote Associate Degree Nursing students to pursue BSN and higher education. Several statewide articulation agreements offer students better advantage at completing BSN. Other innovative programs for completion are also in development. The UWM College of Nursing Flex Option for RNs needing additional college credit to earn their BSN degree began this past fall. This unique program allows students to earn college credits by demonstrating knowledge acquired through coursework, alternative educational activities and professional experiences. Students will progress toward a degree by successfully completing a series of competency assessments that demonstrate mastery of required knowledge and skills. Increasing educational capacity and academic progression are key issues which require time to accomplish. Positive outcomes require public-private partnerships and innovative collaboration. Health reform will refocus care on underserved populations, health promotion and transitional care between community and healthcare facilities. Nurse educators, clinicians and administrators will need to work together and with other disciplines and policy makers to align the nursing profession with individual and population health needs. The complete report is available for free download at http://www.wisconsincenterfornursing.org/workforce_report.html.Q – Submitted by Yvonne Eide, MS, RN, WCN Board of Directors and Judith Hansen, MS, BSN, WCN executive director.
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Nurse residencies: Now coming to long-term care By Diane Farsetta, Ph.D.
It’s not surprising that nurse residencies-ten-week to year-long transition to practice programs offering targeted training Diane Farsetta and mentoring-are increasingly popular among new nurses and their employers. By better supporting nursing staff, residencies improve the quality of care and increase nurse retention rates. The clear benefits have led the Institute of Medicine to recommend nurse residency programs across all care settings, and the National Council of State Boards of Nursing to consider a residency requirement for licensure. For nurses working in long term care, residency programs could be transformational. Long-term care nurses see residents whose multiple chronic conditions and long list of medications complicate routine care and post-acute rehabilitation. These nurses are often faced with challenging quality-of-life and end-oflife situations. Unlike nurses working in hospital settings, long term care nurses often work in relative isolation, are frequently the only RN on site, and lack access to colleagues with specialty expertise. Long term care nurse residency programs could address these issues while helping reduce the staff turnover rate, which is higher in nursing homes than in any other health care setting. But the realities of longterm care also make designing and implementing nurse residencies more complex. Nearly all established nurse residency programs have been developed for hospital settings. These programs generally assume that a group (or cohort) of new nurses will train at the same time, in the same place, with access to experienced mentors or preceptors, and with support from professional development departments. Such hospital-
based models don’t work for most nursing homes, which may hire only one nurse at a time, are less likely to have staff with precepting skills or experience, and have fewer resources for professional development. To be successful, long term care nurse residencies must cover topics as diverse as dementia care, family interactions, management skills, the independence of the long term care nurse, and the regulatory environment. Providing ongoing access to training, accommodating small and/ or geographically dispersed groups of new nurses, training or making experienced mentors available, and keeping costs low are also key. The good news is that nurse residency programs designed for long term care are now becoming available. Developed by the UW-Madison School of Nursing and Oregon Health and Sciences University (OHSU), the Geri-Res curriculum for new nurses and nurses new to long term care covers promoting resident function, geriatric nutrition, end of life care, and communicating with health care teams and families, among other topics. Geri-Res is now being pilot tested in several nursing homes, and 900 nurses from a cooperative of Minnesota nursing homes are taking part in the mentor training modules. After analyzing and incorporating feedback, the UW/OHSU team will make Geri-Res widely available in early 2015. While initially targeted to nursing homes, Geri-Res has broad potential. “Home health, assisted living and hospitals have been following us closely, asking for tracks tailored to their care environments,” Kim Nolet, UW-Madison research program manager, explained. “We’ve also started planning an advanced curriculum for nurses who have worked in long term care for at least six months, but are still developing their geriatric expertise. There’s no shortage of important topics, such
as transitions in care andadvanced dementia care.” This June, a New Jersey coalition will launch a face-to-face long term care nurse residency. Rutgers University College of Nursing and the New Jersey Action Coalition designed the program in response to the Institute of Medicine’s “Future of Nursing” report. “More and more health care will be in the community and long term care, so preparing people for this setting is a priority,” Susan Salmond, RN, EdD, ANEF, FAAN, and dean of the Rutgers College of Nursing told Nurse.com. The program’s first two cohorts of 25 nurses will gain experience in a range of settings, including nursing homes, hospitals, home care and hospice, with an emphasis on transitions of care. Rutgers faculty will provide instruction, in addition to experienced long term
care nurses who have been trained as preceptors. Some 20 participating facilities in northern New Jersey have committed to hiring the trainees. These first two long term care nurse residencies will hopefully inspire and inform other programs. “Ultimately, a variety of options need to be available for long term care nurses,” said Barbara Bowers, PhD, RN, FAAN, associate dean for research and Rodefer Chair at the UW-Madison School of Nursing. “They have gone so long with such little preparation to become geriatric specialists that it’s exciting to see them finally start receiving the support they need.”Q Diane Farsetta is the outreach specialist at the Center for Aging Research and Education (CARE), University of Wisconsin-Madison School of Nursing.
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Nursingmatters
Reprint in a series written by Signe Cooper and introduced by Laurie Glass in March Nursingmatters
Relections of our Heritage Signe Skott Cooper’s legacy Evelyn C Smith 1893-1986
Challenges, adventure took brave nurse to remote locales she rode was not allowed to stop in The career of Jane Theresa some of the towns along the way. Taylor reflected her love of travel Red and yellow flags marked “yeland adventure. Her papers, on file low fever” were flown at the State Historical in front of homes of Society of Wisconsin, the stricken, and visireveal that she served as tors were not allowed a nurse in Panama, in the to enter. Philippines, and as an Army Nurse in France in Taylor worked as a World War I. private duty nurse in Jane was born June 8, patient’s homes dur1874, in Fond du Lac to ing the epidemic, often Arzo Benton Taylor and after the rest of the Jane Woodruff Taylor. family had fled. In an She graduated from article in the Fond du Theresa Taylor Fond du Lac High School, Lac newspaper, she noted, and some time after that “Very often the nurse she entered the St. Luke’s Hospital finds herself alone in a great house Training School in Chicago, receivand in addition to being a nurse, she ing her diploma in 1896. is compelled to be cook, laundress, parlor maid, housekeeper and lady The next year she and a friend of the house all in one.” went to New Orleans to care for patients in a yellow fever epidemic. She did not succumb to yelAt that time, the cause of yellow low fever in New Orleans, and in fever and the role of mosquitoes in 1904 went to Panama as a nurse the transmission were unknown and employed by the U.S. Civil Service. people were frightened of the disThe United States had taken over ease. When the epidemic hit New the building of the Panama Canal Orleans, many people closed their after the French had failed, defeated homes and left the city. Because to a great extent by malaria and yelof the epidemic, the train in which low fever.
Taylor spent five years in Panama, but while she was there she developed dengue fever (also carried by mosquitoes) and had to take a leave of absence to recover. She resigned in 1909. Her last assignment had been at the Colon Hospital, Christobel, Canal Zone. The superintendent of the hospital noted that her service had been highly satisfactory. She received a medal from President Theodore Roosevelt in recognition of her service as a government employee in Panama. She joined the Army Nurse Corps in 1911, only 10 years after it had been established. She served a year at the Presidio in San Francisco and then was sent to Manila for two years. The Philippine Islands were then under the control of the United States. Taylor must have enjoyed her time in the Philippines, for after leaving the Army in 1916, she served as a missionary nurse in Davao, Mindanao. Here she was usually the only nurse in a small and overcrowded hospital at the mission station, and after two years she succumbed to exhaustion. After she
returned home, she received a letter from a friend in Mindanao who wrote, “We trust you are already quite improved ;physically, after all those strenuous months when you had to shoulder the brunt of the responsibility for the care of patients crowded in the little hospital.” But Taylor recovered, and on July 9, 1918, she rejoined the Army Nurse Corps. After serving at Camp Custer, Battle Creek, Mich. she sailed for Europe in a convoy, arriving in France shortly before the Armistice was declared. As a replacement nurse, she served for none months in military hospitals in various parts of France: at Mars sur Allies; at Angers, near Tours; and at Camp Neucon. She was discharged on July 27, 1919 from Camp Stuart, Newport News, Va. Her papers include letters she wrote home during six months of travel in South America in 1931 and 1932 and two months in Mexico in 1935. Additional information about Jane Taylor could not be located.Q The author thanks the Fond du Lac County Historical society for information about Jane Taylor.
Kollenbroich honored by Association of Pediatric Nurse Practitioners Terry Kollenbroich has been selected as Advance Practice Nurse Practitioner of the Year 2014 for the Wisconsin Chapter of National Association of Pediatric Nurse Practitioners (NAPNAP). Terry Kollenbroich Kollenbroich works in primary care pediatrics for Aurora Health Care at the East Troy and the Waterford Pediatrics clinics.
surface of what I Shewas nomiNM needed to know nated by several as a student,” of her students said one. “She whom she preprovided me with cepted. Her stuthe confidence to dents recognized know I have the knowledge to pracher for her ability to educate, mentor tice as an advanced nursing provider and role model what an APN role and she instilled in me the quality of consists of, for her PNP and FNP resourcefulness when I did not know students. They say she is a profesthe answer.” sional PNP that holds herself to very “She has endless patience and high standards. “She took her time allows students to take time to indeto use every patient situation and pendently formulate a diagnosis and every downtime moment to help plan for each patient,” said another. me learn above and beyond just the
CELEBRATIONS
“Her wealth of knowledge is incredible. She takes the time to explain her thought process and the resources that can be utilized when caring for patients. This allows students to understand how to treat and care for pediatric patients. “ Other students said, “ She is the most influential preceptor I have worked with,” “ She’s dedicated to providing great experience for her students,” and “She has a passion that she shows each and every day when working with pediatric patients and their families.”Q
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Graduate nursing student perspectives: Midwest Nursing Research Society Annual Conference, March 2014 Ph.D. student perspective by Ann E. Stanton As a Ph.D. nursing student, my first time at the Midwest Nursing Research Society’s Annual Conference was eye-opening. I learned how nurses at all educational and skill levels were taking part in research and related practice-improvement projects. The conference reinforced the idea that everyone can contribute to building a knowledge base that improves the health and wellAnn Stanton being of individuals, families, and societies. The presentations offered great insights into various research designs, data analysis techniques, and real-life challenges. There were workshops on various topics, from issues with publication to future directions of the field. I found that nurse researchers have endless options in regards to whom and what they study, from concept analysis and nursing education to genetics and global health. I was truly inspired by the idea that now is an important time for nurses to lead the way in advancing health through their commitment and devotion to ongoing learning and practice improvement. I was able to network with nurses and nursing students from all over the Midwest. I learned about their professional interests and received invaluable feedback on my own. As a new Ph.D. student, their support and encouragement went a long way. I heard about how others succeeded through their doctoral programs and beyond to establish themselves as respected nurse scientists. In the professional world of nursing, who we know can be extremely beneficial because they add to what we know and our abilities to apply that knowledge.Q Ann E. Stanton is a BSN-prepared Registered Nurse pursuing a research-focused doctorate in Nursing at the University of Wisconsin-Milwaukee.
DNP student perspective by Jennifer Krueger As a student earning a clinical doctorate in nursing practice, I attended the MNRS annual conference hoping to learn about current research being conducted by nurses in order to better inform my clinical practice. As the nursing profession continues to focus on the importance of using evidence-based practice, the long process of translating research into practice needs to be Jennifer Krueger improved. There were many benefits to attending the conference, including being able to ask presenters questions about their projects. All of the researchers were excited to see a clinician at the conference. They were also eager to explain how their research findings could be applied to various clinical practice settings. As is the case with many other advanced practice nurses, research is an important part of my clinical practice. I realized that the presence of practicing clinicians at research conferences is an effective and efficient way to disseminate findings. This is an essential piece of the research process as it allows clinicians the opportunity to apply the latest knowledge in practice.Q Jennifer Krueger is a BSN prepared registered nurse, pursuing a clinical Doctorate in Nursing Practice at the University of Wisconsin-Milwaukee, and employed as a staff registered nurse at Aurora Health Care.
Master’s degree in nursing now offered at MSOE NM COLLEAGUES CORNER Milwaukee School of Engineering’s School of Nursing will offer a Master of Science in Nursing: Health Care Systems Management beginning in Fall 2014. The demand for well-educated, business-oriented professional nurses in managerial and leadership roles is growing due to the increasing complexity of the health care system. Nurses at mid-management and
executive levels and nurse entrepreneurs must manage financial resources and human capital, analyze large data sets, understand complex organizational systems, and ensure quality and safety, all through the lens of nursing practice. The new MSN degree at MSOE meets this need and is unique in that many courses are co-taught. For example, the first half of “Statistical
Thinking and Data Analytics” is taught by faculty in the Rader School of Business. The second half is taught by faculty in the School of Nursing who will then apply the business learning to a health care setting. The MSN in Health Care Systems Management is best described as a graduate degree in nursing blended with business concepts. The unique
blend of nursing, business and engineering concepts will equip graduates with the knowledge and skills necessary to function effectively in the health care environment. Courses are available via blendedInternet format, combining the benefits of face-to-face interaction with the convenience of online learning. More information is available at www.msoe.edu/nursing.Q
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Nursingmatters
Breastfeeding and the environment By Anne Dressel, Betty Koepsel, and Dalvery Blackwell
The University of WisconsinMilwaukee (UWM) College of Nursing and the African American Breastfeeding Network of Ann Dressel Milwaukee (AABN) recently completed a successful collaborative project that focused on breastfeeding and environmental health education Betty Koepsel in the Westlawn community. This project built upon work that has been ongoing since 2008 by the Westlawn Partnership for a Healthier Dalvery Blackwell Environment (WPHE), which the UWM College of Nursing coordinates. Encompassing both overarching goals of Healthiest Wisconsin 2020: improve health across the life span, and eliminate health disparities and achieve health equity, the project addressed infant nutrition and environmental health risks for babies, mothers, and families living in Westlawn. Located in Milwaukee, the Westlawn community includes Wisconsin’s largest publicly-subsidized housing project, and the surrounding neighborhood within the 53218 zip code, which has 43,494 residents. Westlawn is a low-income, predominantly African American community, of which 51 percent are children ages 17 and under, and 93 percent of heads of households are female. According to the CDC, breastfeeding rates for low-income African American women are among the lowest of all groups in the U.S. Breastfeeding initiation rates for lowincome African American women are 37 percent compared to 75 percent for the overall U.S. population. The disparities in breastfeeding rates can contribute to other immediate health concerns such as higher infant mor-
tality rates, and to other health disparities that appear later, such as higher rates of obesity, ear infections, and asthma, according to the American Academy of Pediatrics. These health disparities are readily apparent in Westlawn. At the inception of this project, the infant mortality rate in Westlawn was 16.9, which was nearly twice as high as the infant mortality rate for the City of Milwaukee (9.3), and almost triple the rate for the State of Wisconsin (5.7). In addition, asthma rates in Westlawn are among the highest in the state. According to Fight Asthma Milwaukee Allies, children living in the Westlawn neighborhood are four times more likely to visit an emergency room for asthma attacks compared to the rest of the state; and more than three times more likely to be hospitalized for asthma compared to the rest of the state. Thus, increasing breastfeeding rates among women in Westlawn could improve the health of women and their babies now, and potentially, improve the health of the children as they grow up. Supported by a small grant from the UWM Community/University Partnerships program, a series of monthly classes was developed that focused on connections between breastfeeding and the environment. Improving indoor air quality to reduce asthma triggers in Westlawn homes has been an ongoing focus of the WPHE. Classes were developed by the AABN Program Manager, a UWM College of Nursing Clinical Assistant Professor who also serves as the Project Coordinator for the WPHE, and by 16 undergraduate UWM College of Nursing students. The UWM students also assisted in teaching the classes to Westlawn residents. The class topics included information about the value and benefits of breastfeeding, the health benefits of using “green cleaning� (non-toxic) products, integrated pest management (non-toxic pest-control methods), and the impact of smoking on nursing babies and as an asthma trigger in the home environment. The series of classes was offered in the 2012-2013 academic year, and 33 Westlawn resi-
dents attended the classes. Feedback from and evaluations by residents were very positive, with comments such as, “I expected this class to be boring, but I learned far more than I’d expected to!â€? and, “The classes have been great – I learned something new at every session!â€? In addition to benefitting Westlawn residents, UWM Nursing students gained a first-hand understanding of how the environment impacts health. More importantly, the students witnessed the direct effects of health disparities in the Westlawn community. Students learned about the real women behind the impersonal aggregated statistics that they read about in their textbooks. These were caring, intelligent, compassionate women who wanted what was best for their children and attended the classes to learn how to improve the health of their families. Like other health care professionals, UWM Nursing students had learned about the health benefits of breastfeeding. While the students and many nurses are aware of the potential harm of environmental contaminants in breast milk, which can cross from mother to baby, very few are aware of the effects of formula feeding on the environment. The ANA Code of Ethics states that “the nurse has a responsibility to be aware not only of specific health needs of individual patients, but also of broader health concerns such as‌ environmental pollutionâ€? (Provision 8.1). Students and WPHE members were educated about these effects by the AABN Program Manager. Breastfeeding is good for the environment in a number of ways (adapted from W. Correa, Mothering Magazine). sÂŞÂŞ"REASTFEEDINGÂŞSAVESÂŞENERGY ÂŞ&ORMULAÂŞ production requires the transportation of raw materials to the processing plant to make infant formula, followed by shipping the product to stores, where parents have to drive to buy it. sÂŞÂŞ"REASTFEEDINGÂŞSAVESÂŞTHEÂŞEARTH ÂŞ-OSTÂŞ formula is made from cow’s milk. Maintaining cows requires extensive tracts of land, water, and feed for the cows. As with other industries
that rely on cattle, deforestation and soil erosion are byproducts of clearing land in order to make room for cattle to graze. In addition, formula is packaged from materials that must be manufactured, such as paper, plastic, and tin. For every 3 million formula-fed babies, 450 million cans of formula are consumed. The resulting 70,000 tons of metal in the form of discarded cans is often not recycled. sªª"REASTFEEDINGªSAVESªTHEªAIR ª!Sª previously stated, formula requires packaging, the manufacturing of which produces toxic fumes which are released into the air. In addition, methane gas released from cows contributes to air pollution, as well as climate change. sªª"REASTFEEDINGªSAVESªTHEªWATER ª Because most formula is made from cow’s milk, run-off from industrial cattle production can contaminate our water supplies. Run-off from sewage is problematic, as well as from pesticides and insecticides applied to crops which are used to feed the cows.Q UWM College of Nursing faculty, staff, students, and the community members involved in this project learned about the benefits of breastfeeding for mothers and infants, as well as for the environment – a benefit to us all.
Author Information: Anne Dressel, PhD, CFPH, is the Director of the Center for Global Health Equity in the UWM College of Nursing. She is also Project Director of the Westlawn Partnership for a Healthier Environment. Work Phone: (414) 229-3995 Betty Koepsel, MSN, RN, is a Clinical Assistant Professor in the UWM College of Nursing and serves as Project Coordinator of the Westlawn Partnership for a Healthier Environment. Work Phone: (414) 229-5694 Dalvery Blackwell, BA, IBCLC, is Co-Founder and Program Manager of the African American Breastfeeding Network of Milwaukee. She is also a member of the Westlawn Partnership for a Healthier Environment. Work/Home Phone: (414) 617-3441
We are currently seeking candidates for the following position:
PUBLIC HEALTH NURSE Marquette County, Wisconsin, is accepting applications for a half-time Public Health Nurse. This position in our Health Department will provide health education, health promotion, health assessment, public health preparedness, and disease prevention activities in the community and schools. Qualifications: Bachelor’s degree from an NLN accredited nursing program or a Public Health Certificate, a current license as a registered nurse in the State of Wisconsin and prefer 1 year public health or general hospital experience. CPR certification and valid WI driver’s license with access to a vehicle required. Pay range is $24.10/hour $28.35/hour based on qualifications and experience, plus prorated health, dental, retirement and life insurance are available. Required application and full job description are available on the County’s website www.co.marquette. wi.us or by contacting Administration at 608-2973001, or e-mail kmcreath@ co.marquette.wi.us. Submit application materials to Administration Office, Room 101, 77 W. Park Street, P.O. Box 129, Montello, WI 53949, fax (608) 2977606, or email kmcreath@ co.marquette.wi.us. Application deadline Friday, June 27, 2014 at 4:30 p.m. EOE.
REGISTERED NURSE Mile Bluff Medical Center has currently has full time and part time positions available in our Emergency Department. The successful candidate will be responsible for assessing, planning, directing, coordinating, evaluating, and providing care for patients in a rural Trauma Category Level 3 Emergency Department. The RN will work with other members of the ER team in a collegial environment to provide care for patients of all ages. The ER team is dedicated to providing high quality standards of care for all ill and injured patients. Requirements include a 2 year minimum of nursing experience in a progressive healthcare environment, CPR and ACLS certifications, and current RN licensure. One year minimum nursing experience in the Emergency Department or Critical Care and TNCC, ENPC, and PALS certifications preferred. Mile Bluff Medical Center is a rural facility located in South Central Wisconsin on I90/94, 70 miles from Madison and LaCrosse. For more information on our facility, please visit our website at www.milebluff.com. Interested candidates may send resume to: Mile Bluff Medical Center Attn: Human Resources 1050 Division St. Mauston, WI 53948 (608) 847-1461 An Equal Opportunity Employer
Exceptional Women’s Health (OB) Nurses Needed Does your heart smile each time a new life is brought into the world? Do you have a passion to provide each patient a personalized and unique experience? Do you have a desire to use your critical nursing skills in a “state of the art “ Women’s Health Center? Have people told you that you are the most compassionate person they know? If so, we invite you to get to know Watertown Regional Medical Center, where we are transforming the way women’s healthcare is delivered. The vision for our newly built addition was created by asking women “What matters most?” when it comes to healthcare. This community and staff input guided the creation of a special women’s health unit, where technology and patientcentered processes are designed to make each and every patient feel like they are our one and only.We serve women at all stages of life, from labor and delivery to gynecological care on a brand new women’s health unit. If you are ready to make a special difference at a very special place, we encourage you to apply. Exceptional professional development and competency based educational opportunities available through require off-site training. Opportunities are available on various shifts for full time and part time positions.
http://www.uwhpwatertown.com/Main/WomensHealth.aspx Well-qualified candidates will have an Associate Degree in Nursing, BSN preferred. Experience in LDRP nursing preferred. Current licensure by the Wisconsin State Board of Nursing. CPR required on hire or within 60 days of hire. Neonatal Resuscitation Program certification also required on hire or within 6 months of hire. EEO/AAP Employer
Find Career Opportunities posted continually throughout the month on Nursingmatters online.com
Maternity CliniCal nurse speCialist For qualifications and experience required, please view position online at:
www.bellin.org/careers
EOE - Tobacco Free Environment
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Nursing Supervisor
Correctional Nursing Wisconsin Department of Corrections Passion, Commitment, Autonomy
Correctional Nursing, where caring and passion come together. We are currently recruiting for full time Nursing Supervisors to fill vacancies within the Wisconsin Department of Correctional Institution. Current Vacancies: Columbia Correctional Institution, located in Portage, WI and Racine Correctional Institution, located in Racine, WI. These positions supervise health care staff; develop procedures and techniques to assure that health care programs are functioning effectively; monitor off-site health providers; assure that health care plans are carried out in accordance with policies and procedures; provide liaison to institution staff, psychological services, social services, and other treatment programs to coordinate treatment plans, and work with the primary care physician, dentist, psychiatrist, serving as a consultant to provide quality health care.
Salary - Nursing Supervisor: $84,862 to $104,000 annually, depending on qualifications. Current licensure is required. Excellent benefits package to include: immediate coverage under the Wisconsin Retirement System, Health Plans available to meet your needs at low premiums, Sick Leave, Unused sick time converted to extended health care benefits upon retirement, paid vacation, 4.5 personal days each year, paid legal holidays per year, Life insurance, Supplemental retirement saving program, and Worker’s compensation.
Application Information
For a detailed job description and application information, please see http://wisc.jobs JAC 1401949
We are an Equal Opportunity Employer
RN, Medical Management Manager Wisconsin Physicians Service Insurance Corporation (WPS) is a Madison, Wisconsinbased health insurance and benefit administration company serving federal, state, and commercial clients. With more than 65 years in business, we emphasize uncompromising business ethics and innovative solutions to today’s health care environment. A not-forprofit insurer, our mission is to provide service and value considered by our customers to be the very best. We are seeking a Medical Management Manager who will possess: • Registered Nurse (RN) license • Five years clinical, health insurance or managed care experience with a strong emphasis leading operational functions • Three years supervisory experience Key Responsibilities: • Planning, development, management direction, and oversight of the WPS Medical Management function (Integrated Care Management, Utilization Management, Behavioral Health, and Phone Intake) • Manage inventory and staff to assure timely work completion and compliance with all policy and procedures, work standards, and company policies. Critical Competencies: • Familiarity with utilization management and care management functions and best practices • Proven management skills with the ability to hire, train and evaluate staff • Proven leadership skills with the ability to motivate others and work collaboratively with teams • Well-developed skills in planning, organizing and staff development • Professional oral and written communication skills • Proficient in the use of a PC and software applications (preferably Microsoft Office) We offer a competitive salary, comprehensive benefits and an opportunity to engage and grow professionally. If you want to drive innovation, we encourage you to apply. Visit our web site and apply on-line at www.wpsic.com.
Named One of “World’s Most Ethical Companies” for the Fifth Year in a Row
Equal Opportunity/Affirmative Action Employer
Page 12
June-July • 2014
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Be part of something REMARKABLE Advanced Practice and Leadership Opportunities at Wisconsin’s #1 Hospital Visit uwhealth.org/careers or contact Melissa Holman, senior nurse recruiter, mholman2@uwhealth.org or 800-443-6164 to discuss these positions: • Clinical Nurse Specialists - Oncology - Adult Pain
• Clinic Managers - Urology - Neurology
• Nurse Education Specialists - Pediatrics - Emergency/Psych/ Radiology
• Clinic Coordinator GI Oncology
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