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Quarterly Circulation 23,000 to Registered Nurses, LPNs, LNAs, and Student Nurses in New Hampshire.

April 2014 Official Newsletter of New Hampshire Nurses Association Vol. 38 No. 2

Inside...

NHNA Board Changes . . . . . . . . . .page 2

President’s Message . . . . . . . . . .page 3

Legislative Update . . . . . . . . . pages 4-5

Complimentary Therapies . . . . . .page 5

In My Opinion . . . . . . . . . . . . . . . .page 6

Board of Nursing News . . . . . . . . .page 7

Hand Hygiene . . . . . . . . . . . . . . . .page 8

Gift of Mentoring . . . . . . . . . . . . . .page 9

Nurses Week 2014 . . . . . . . . . . .page 10

Special Event, June 21 . . . . . . . . page 11

Aiding Typhoon Victims . . . . . . .page 12

Students in Costa Rica . . . . . . . . page 14

Action Coalition Update . . . . . . .page 15

In Memoriam . . . . . . . . . . . . . . . .page 16

Member Welcome . . . . . . . . . . . .page 18

Membership Application . . . . . .page 19

Please be sure to notify us with address changes/corrections. We have a very large list to keep updated.

If the nurse listed no longer lives at this address–please notify us to discontinue delivery. Thank You!

Please call (603) 225-3783 or email to office@nhnurses.org with Nursing News in the subject line.

am a member of the New H a m p s h i r e N u r s e ’ s Associat ion

for several reasons. First, this is the best way to have a voice in issues that affect both my practice and my profession. Our country is based on the idea that everyone can have a voice in government, and the larger the group, the louder the voice! Healthcare is changing rapidly and not all for the good. We can no longer afford to sit on the sidelines and watch what’s happening, we need to be right up front, speaking out for both ourselves and our patients, or we’re going to get left in the dust. Don’t think the doctors are not participating and supporting their professional organizations; they most certainly are, and they are quite able to affect change that benefits them. So are we! We just have to do it.

Second, being a member allows me to participate on one of the Commissions,/‘working groups’ of NHNA. I have found this to be an immensely rewarding experience. I feel like I am actually contributing something to the welfare of my profession and it’s a good feeling.

Third, this is a great way to meet new nurse friends and network in the community. We all know how hard it is to meet new people sometimes, and often we don’t really associate with our colleagues outside of work. If you come to meetings, join a Commission, attend a conference - you will find there are a lot of really bright, interesting, active nurses out there! I sincerely hope you will consider joining and being an active member of this wonderful organization. I believe you will find that it is well worth it.

~ Mary Ellen King, BSN, CPN

Why I’m a Memberl t h o u g h I c a n’t remember all of the s p e c i f i c r e a s o n s of why I wanted to become a nurse

thirty years ago, I do know why I stay in the profession and why it is so critical for me to be an active member of NH Nurses Association. The first provision of the American Nurses Association (ANA) Code of Ethics for Nurses (2010), sums it up better than I ever could: The nurse, in all professional relationships, practices with compassion and respect for the inherent dignity, worth and uniqueness of every individual, unrestricted by considerations of social or economic status, personal attributes, or the nature of health problems. And that is only provision one! In this age where pursuing our profession has the potential to be diluted into purely an economic choice, it is imperative that we not allow the philosophy, ideology and ethics of our profession to be diminished as we experience exponential growth and greater autonomy. New Hampshire Nurses Association (NHNA), the NH constituent of ANA, acts as our steward in maintaining the professional integrity of NH nurses.

We are living in very challenging times, where the gap between the haves and the have-nots has never been greater. Nurses face moral dilemmas daily as we seek to increase equitable access and decrease social and economic disparities. NHNA has been on the forefront of promoting legislation that expands access, decreases inequalities and holds nurses accountable for providing compassionate, patient centered care in whatever venue we may choose to practice. NHNA is the compass that provides us with the direction, leadership and professional development needed to tackle these challenging times. NHHA and the ANA provide us with something bigger than ourselves -and articulates to the nation, the values are profession is based on: the promotion of health, well being and social justice; accountability for our practice; and maintaining the integrity of our profession and practice. Please support NHNA, as they support us, our patients, and our communities.

~ Barbara McElroy, CRNI, OCN

American Nurses Association. (2010). Code of ethics for nurses with interpretive statements. Retrieved from http://www.nursingworld.org/MainMenuCategories/EthicsStandards/CodeofEthicsforNurses/Code-of-Ethics.pdf

I A

Page 2 • New Hampshire Nursing News April, May, June 2014

The following members have assumed new roles with the Association.

Peggy Lambert, RN, MS, MBA, CCRN was voted in as

President Elect.

B a r b a r a j o ( “ B J ” ) Bockenhauer, MSN, ARNP, PMHCNS-BC moved from President Elect to the President’s role and Judith Joy, PhD, RN now holds the ‘Immediate Past President’ position on the Board.

Carlene Ferrier, RN, MPH – was elected as the organization’s

new Treasurer.

New Directors at Large are: Carmen Petrin, MS, APRN, FNP-BC

and

Suzanne Riley, BS, RN, ACLS, PALS.

Published by:Arthur L. Davis

Publishing Agency, Inc.

www.NHNurses.org

NURSING NEWSVol. 38 No. 2Official publication of the New Hampshire Nurses’ Association (NHNA), a constituent member of the American Nurses Association. Published quarterly every January, April, July and October. Library subscription rate is $24. ISSN 0029-6538

Editorial OfficesNew Hampshire Nurses Association, 25 Hall St., Unit 1E, Concord, NH 03301. Ph (603) 225-3783, FAX (603) 228-6672, E-mail Avery@NHNurses.org

Editor: Susan Fetzer, RN, PhDAssociate Editor: Holly Clayton

NHNA StaffAvery Morgan, Executive DirectorFaith Wilson, Admin. Assistant

NURSING NEWS is indexed in the Cumulative Nursing Index to Nursing and Allied Health Literature (CINAHL) and International Nursing Index.

For advertising rates and information, please contact Arthur L. Davis Publishing Agency, Inc., 517 Washington Street, PO Box 216, Cedar Falls, Iowa 50613, (800) 626-4081, sales@aldpub.com. NHNA and the Arthur L. Davis Publishing Agency, Inc. reserve the right to reject any advertisement. Responsibility for errors in advertising is limited to corrections in the next issue or refund of price of advertisement.

Acceptance of advertising does not imply endorsement or approval by the New Hampshire Nurses Association of products advertised, the advertisers, or the claims made. Rejection of an advertisement does not imply a product offered for advertising is without merit, or that the manufacturer lacks integrity, or that this association disapproves of the product or its use. NHNA and the Arthur L. Davis Publishing Agency, Inc. shall not be held liable for any consequences resulting from purchase or use of an advertiser’s product. Articles appearing in this publication express the opinions of the authors; they do not necessarily reflect views of the staff, board, or membership of NHNA or those of the national or local associations.

VISION STATEMENTCultivate the transformative power of nursing. Adopted 10-20-2010.

MISSION STATEMENTNHNA, as a constituent member of the American Nurses Association, exists to promote the practice, development and well being of NH nurses through education, empowerment and healthcare advocacy.Adopted 10-20-2010.

NH Nursing News (NHNN) is the official publication of the NH Nurses’ Association (NHNA), published quarterly – and available in PDF format at our website: www.nhnurses.org Views expressed are solely those of the guest authors or persons quoted and do not necessarily reflect NHNA views or those of the publisher, Arthur L. Davis Publishing Agency, Inc. NHNA welcomes submission of nursing and health related news items, original articles, research abstracts, and other pertinent contributions. We encourage short summaries and brief abstracts as well as lengthier reports and original works. An “article for reprint” may be considered if accompanied by written permission from the author or publisher. Authors do not need to be NHNA members.*

Manuscript Format and Submission:Articles should be submitted as double spaced WORD documents (.doc format vs. .docx, please) in 12 pt. font without embedded photos. Photos should be attached separately in JPG format and include captions.

Submissions should include the article’s title plus author’s name, credentials, organization / employer represented, and contact information. Authors should state any potential conflict of interest and identify any applicable commercial affiliation. Email as attachments to avery@nhnurses.org with NN Submission in the subject line.

Publication Selection and Rights:Articles will be selected for publication based on the topic of interest, adherence to publication deadlines, quality of writing and peer review. *When there is space for one article and two of equal interest are under review, preference will be given to NHNA members. NHNA reserves the right to edit articles to meet style and space limitations. Publication and reprint rights are also reserved by NHNA. Feel free to call us any additional questions at 603-225-3783.

Advertising:Product, program, promotional or service announcements are usually considered advertisements vs. news. To place an ad, contact: Arthur L. Davis Publishing Agency, Inc. Email sales@aldpub.com or call 800-626-4081. Ad sales fund publication and mailing of NH Nursing News and are not paid to NHNA.

Guidelines for Submissions to NH Nursing News

Changes in the NHNA BoardAs 2013 came to a close, so did the terms of three of our Board of Directors: Jane Leonard, MBA, BSN, RN; F. Joseph Desjardins, MEd, BSN, RN-BC. and Michelle Pelletier, BSN, RN, BC. We thank each of them for their dedicated service and commitment to NHNA.

2013 President, Judy Joy

presented awards to Joe

Desjardins & Michelle Pelletier

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April, May, June 2014 New Hampshire Nursing News • Page 3

Letter from the President

Barbarajo “BJ” BockenhauerMSN, ARNP, PMHCNS-BC

We’re not talking tomatoes here. Just sayin’.

As I look outside to ice and snow and feel the chill that seeps in through my under-insulated walls, it seems that this scene will never change, much less transform. Thankfully, inductive reasoning directs me to consider the possibility that my emotional reaction may be inaccurate. The relationship between the earth and the sun as well as NH’s relationship to the equator provides evidence to support the hypothesis that the transformative phenomenon of “spring” will occur sometime within the next several weeks. I also have many “lived experiences” of seasonal changes, adding phenomenological data to the evidence that these changes will occur more or less when they are expected.

Other than being bombarded with messages regarding our role in affecting the global climate, changes associated with seasons place no particular burden on the individual. This is not the case with regard to the challenges to the promotion of the practice, development and well being of NH nurses. Those changes are both dependent on and responsive to NHNA actions. I am proud to note that NHNA embraces the constant of these “changes” and is deep into a transformation of its own.

The Serenity Prayer suggests that the challenge is to wisely consider the use of acceptance or courage in the face of the change. I’ll come back to that acceptance path, but want to focus on the courage option.

Cultivating transformation in nursing, rather than in tomatoes, requires that NHNA provide the resources that will support nurses’ engagement in the changes that transform. Prochaska* et al’s formulation of a model for change provides, for me, a clear and easily recognizable description of the process. Prochaska et al contend that individuals require information in order to move from precontemplation – not knowing or recognizing our intent to change – to contemplation – seriously considering a change and figuring out what keeps us from being able to make a commitment to enact that change. The process of change, rather than being a constantly forward-moving activity is characterized as more of a spiral, with a predictable circling back over issues already, but not completely, addressed.

I review this model as a message of hope when we find ourselves challenged by “the same old” concerns. Given the tremendous energies and commitment of our members, I believe we can embrace and address these issues from the perspective of evolution. As NHNA continues to evolve in its role as a member in the Northeast Multistate Division, I welcome the opportunity to share a transformative perspective on our activities to this point.

NHNA has been participating in a pilot project that makes it more affordable to be a member – currently $13/month for both NHNA and ANA membership. So many of you have taken advantage of access to ANA resources, including reduced programming and certification fees that we have increased our membership by 28% in the last 6 months.

In addition to becoming more affordable, NHNA has also worked to make itself more meaningful to the membership. The secret? Give membership something to do that has meaning– like, for one, letting them know their vote counts!

At last year’s Legislative Town Hall, you voted make “Medicaid Expansion” our primary legislative focus. There is no perfect solution to the health care problems in this state. However, you felt that it was important to give 50,000 uninsured NH residents an opportunity to develop a relationship with a primary care provider so that their asthma or diabetes or hypertension is managed in the office, rather than the Emergency Department or ICU.

At your direction, NHNA was a proud and active member of a coalition of health-focused agencies and advocacy groups who worked together to develop and enact strategies in support. Past President Judy Joy and one of NHNA’s Mentor volunteers Deb McCarter-Spaulding wrote powerful Opinion Editorials that were picked up in over twenty newspapers statewide. In response to NHNA’s email “blasts,” you called your Senator, or had coffee with him or her, or wrote a letter sharing your interest in this issue and asking for support of SB 413.

Our legislators listened when members of the “most trusted profession” told them that we cared about the health of 50,000 underserved NH residents. In our testimony, we contradicted those who suggested that the state did not have enough providers to give these individuals care. We said nurses and advanced practice nurses were ready and willing to accept that challenge..

Even though it took longer than hoped for, you can share in the achievement of SB 413 passing the Senate 18-5 and, by the time you read this, the bill will have passed the House and may be law. We believe that the nurse’s well being will be improved when the nurse can know that the patient is actually going to be able to afford the medication or follow-up that the nurse is teaching them about. It just makes sense.

And here’s another thing to let members know that may be meaningful – you have a friend in NHNA. Relationships are a key factor in well being, of nurses and everybody. In this past year, the Nursing Practice Committee made sure we had a way to build value-laden relationships – the Mentorship Program. By checking out our website members can volunteer to be a supportive colleague OR find a supportive colleague. Whether you need to work through a decision about your career track or a complex care issue, there is likely to be a mentor who would like to help. And, your expertise would be likely to be helpful to your colleagues.

And finally, I’d like to share an update on the continuing transformation inherent in our shift from an ANA single state nursing association entity to a member of the Northeast Multistate Division, an MSD member. Together with Maine, Vermont, Connecticut, and Rhode Island, New Hampshire is engaged in a consolidation and stream-lining of its processes. Many efficiencies of service are

subtle, such as our website and its soon to be updated style. Some are in the pipeline and will be more obvious, such as the changes to our continuing education process.

The CE Commission has made a firm commitment to working out any bugs that may be encountered as we transform to the Multistate Division way of managing CE. Forms and processes will be changing soon and shared staff coverage will increase our customer service abilities. As the first of the states in our division to “go live” with a specific collaborative activity, the Continuing Education Commission is excited to begin. They are also understandably concerned that we hold on to the elements of our individual system that have meaning to NH Nurses. Stay tuned for changes to our continuing education process that should make the process of applying and renewing CE matters substantially less complex and time-consuming.

Transformative experiences are, by definition, life changing in small or large ways. Many of us have had the courage to devote thoughtful time and energy to our personal and professional life changes. Some of these changes were transformative; some were not. To those lucky and skilled enough to incorporate change and transformation without angst and chocolate, my congratulations and awe are with you. To those who stumbled and fumbled your way through change and transformation, gaining grey hair and a wardrobe of stretch waistband attire while losing friends through your missteps, you are my sisters and brothers. We are also transformed, and have learned so much along the way.

NHNA, while fully engaged in its own transformative process, remains committed to the practice, development and well being of NH nurses through education, empowerment and healthcare advocacy. There will always be more transformative and, I hope, meaningful information to share. I hope these few words have given you some sense of the meaning that membership in NHNA can provide.

* James O. Prochaska is a Professor of Psychology and director of the Cancer Prevention Research Center at the University of Rhode Island and developer of the Transtheoretical Model of Behavior Change beginning in 1977.

“ALDNH”

Page 4 • New Hampshire Nursing News April, May, June 2014

NH Legislative Summary 2014Respectively Submitted,

Bobbie D. Bagley, GAC Chair

The NHNA Government Affairs Commission (GAC) strives to represent the voices of NH nurses on legislative and health issues in the political arena in the state of NH. As the largest professional group serving in New Hampshire’s healthcare workforce, nurses have the opportunity to make a huge impact on critical healthcare issues. Two major areas of focus for the Commission have included: • IdentifyinglegislationthatGACwouldprioritizeandsupport.• Planninglegislativeevents toinformandengagenursesinimportanthealth-related

policy matters.

GAC welcomed three new members to the Commission: Barbara Cormier, Sherrie Palmeri, and Lawrence Spector. Returning members included: Bobbie D. Bagley, serving as the new chair, Lea Ayers-LaFave, Mary Bidgood-Wilson, Ginny Blackmer, Carlene Ferrier, Patricia Finn, Paul Mertzic, Susan Smith, and Linda von Reyn. Ad hoc participant advisors include: Lisah K. Carpenter and Rep. Laurie Harding. Barbarajo Bockenhauer, NHNA President, and Judith Joy immediate Past President, are Ex Officio members. Robert Dunn continues to serve as the NHNA Lobbyist providing legislative updates to the GAC.

Discussions on the Medicaid Expansion Study Commission and the bill on Medicaid Expansion were monthly agenda items. GAC members were actively involved in the support of Medicaid Expansion, attending meetings, calling legislators and mobilizing NHNA members to get involved. The following written support was submitted on behalf of the NHNA:

NHNA, representing over 20, 000 NH nurses and advanced practice nurses, applauds the efforts of the Senate to negotiate a bipartisan plan that will assure access to healthcare for the most needy of NH residents. As clinicians, we are at the bedside teaching fast food workers and self-employed painters about medications and follow-up care that they cannot access. We are also in the Emergency Departments, seeing individuals whose care is an emergency only because of the absence of the ability to have preventative care and/or follow-up for their ongoing medical needs. And finally, we are in our offices treating infants and children whose parents have no healthcare options. Providing access to healthcare is the right thing to do. The opportunity to provide access to healthcare is now. NHNA urges the House to support SB 413.

Sincerely,Barbarajo (BJ) Bockenhauer, MSN, APRN, PMHCNS-BCPresident, NH Nurses Association.

UPDATE: At this writing we are pleased to report that SB413 passed the Senate – and we thank all NH nurses who made contacted their Senators. Passage by the House is anticipated.

This year the GAC decided to take a new approach to education events but combining Health Policy Day and the NHNA Town Hall to create a dynamic, Legislative Forum which was held via video conference at six sites around the state on January 29th. This

process included identifying legislation with support from R. Dunn and L. Harding that would impact NH citizens and the nursing profession. During each meeting, a legislative update was provided and Commission members weighed the intent and pros and cons of each bill introduced on topics including mental health courts, surrogacy/guardianship, facility licensing laws, palliative care, oral health and dental hygiene.

A total of 344 registrations were received with 255 actually attending (150 of whom were nursing students – including many enrolled in an RN-BS program). The evening kicked off with a review of how a bill becomes a law presented from the Laconia site by Ginny Blackmer. From the Concord location, lobbyist Bob Dunn, President Bockenhauer and Kitty Kidder (NH Board of Nursing), spoke on the different roles of NHNA, the BON and the professional lobbyist. Participants were also able to spend interactive time with legislators at each of the sites. During the second half of the forum, Lisah Carpenter led attendees through an overview of the Forum and voting process. Five bills were presented (see bill language below). Aside from receiving the list of bills to review prior to the evening event, the effect, history, sponsors as well as pros and cons of the bill were presented. Participants were then able to engage in an informed open debate on the bills and voted on the priority bill for NHNA focus during this legislative session.

HB 1434 Relative to surrogate healthcare decision-making by family or friend

EFFECT: Establishes a process whereby a hospital representative can acknowledge and act on healthcare decision-making authority of a family members or friend of an individual who hasn’t established an advanced directive but AND does not currently have the capacity to make health care decisions.

SPONSORS/Supporters: Laurie Harding D (Grantham) and two other Democrats

SB 213 Establishing a registry for life-sustaining treatment records

EFFECT: Establishes the NH POLST (Physician Orders for Life Sustaining Treatment) Registry that gives the patient and physician/APRN /PA the opportunity to establish an “actionable medical order” to assure that the patient’s preferences relative to life-sustaining treatment are followed. Bill establishes: 1- HHS-managed registry for collection and dissemination of POLST to authorized care-givers and researchers 2- POLST forms and their dissemination for use, 3- education of public and healthcare professionals about POLST, 4- POLST advisory committee that will include two “health professionals “who have knowledge of POLST” as well as public members, physician, hospice rep, long term care rep and two public members (one of whom must be a minority).

SPONSORS/Supporters: Sen. John Reagan R and bipartisan group of 9 Senators

HB 1622 An act permitting qualified patients and registered caregivers to cultivate cannabis for therapeutic use

Forum attendees at Nashua location

President Bockenhauer meets with Senator Nancy Stiles

GAC Volunteer Barbara McElroy, Sen. Martha Fuller-Clark, Past Pres. Judy Joy

Lobbyist Bob Dunn, GAC member and NHNPA Exec. Director Mary Bidgood-Wilson and Pres.

Bockenhauer attending hearingsPanelists speaking from Concord

video site

Sen. D’Allesandro speaks to Forum attendees at St. Anselm College

NH Legislative Summary 2014 continued on page 5

April, May, June 2014 New Hampshire Nursing News • Page 5

EFFECT: Establishes the parameters whereby an individual aged 21 or older, with no felony convictions can cultivate and distribute cannabis for up to five patients (or 9 patients) if a cannabis distribution center is not within 50 miles.

SPONSORS/Supporters: Representative Wright et al, Senator Reagan

SB 318 Establishing the crime of domestic violence

EFFECT: The “new crime” is simply the “old crime, with a designation that it occurred within a domestic relationship.” As of 1/1/2015, law enforcement officers would have the option , as an example, to charge “Simple assault/domestic violence” rather than “Simple assault.” As a result, evidence of the incidence and pattern of domestic violence in this state would be accessible and relevant to decisions made by courts and social agencies.

SPONSORS/Supporters: Bipartisan sponsorship in Senate and House, currently in Senate Judiciary Committee, to full Senate vote on Feb. 6. Supported by Department of Justice, NH Chiefs of Police Association, New Hampshire Legal Assistance, courts, Department of Safety, and NHCADSV with their 14 member programs.

HB 1351 Prohibiting tanning facilities from tanning persons under 18 years of age

EFFECT: Within 60 days of passage, would require that tanning facility operators require proof of age from each person using a tanning device. Does not include any directive regarding consequences.

SPONSORS/Supporters: David Miller (Rochester), Barbara French RN (Henniker), Tara Sad (Cheshire). Introduced 1/8; referred to Executive Departments and Administration

NH Legislative Summary 2014 continued from page 4 Each site engaged in very meaningful discussion on each of the bills presented. The following table represents the results of the final vote of the participants:

HB1351 HB1434 HB1622 SB213 SB318

CONCORD 0 6 2 3 8

KEENE 0 0 9 0 0

LACONIA 0 5 2 1 0

LEBANON 0 4 2 2 8

MANCHESTER 0 19 22 15 14

NASHUA 0 5 0 10 75

TOTAL 0 39 37 31 105

The GAC was pleased with the outcome of the new format of the combined meeting. Despite some technical difficulties with the live video conferencing, survey evaluations showed overall agreement that the event was informative and worth their time attending (97%); learned that importance of the nurse’s role in political advocacy (97%) and 68% answered yes to attending a similar forum next year, with 27.5% responding maybe. The GAC will continue to use this as a medium to keep nurses informed and engaged in legislative issues.

Additionally, our GAC was invited to participate in a pilot program with ANA: the Nurse Political Action Leader (N-PAL). This is an exciting opportunity for us to identify nurses to represent NH working directly with members of Congress on issues that affect nurses. These nurses would serve as liaisons to NH federal legislators.

A Nurses’ Journey Into Complimentary Therapies

Rebecca Marden MSN, CNML, RNClinical Nurse Manager

Pediatric/Adolescent CareNew Hampshire’s Hospital for Children

Kids are kids, even when they are sick. As a pediatric nurse, this is the philosophy that has always been imbedded into my care. From singing softly to a fussy infant, playing peek-a-boo with a toddler, taking an imaginary carpet ride with a school-age child to engaging the anxious teenager about the latest fashion faux pas; these were all ways that I felt that I could contribute to their well-being beyond just medicine.

I have experienced first-hand how music helped relax a young child who suffered from a fractured femur and had severe muscle spasms, music reduced his heart rate, respiratory rate, and muscle tone. I have seen a reclusive, non-engaged teenage boy with autism begin to smile and make eye contact while playing with maracas. I will never forget the smile on the newly trached 2-year-olds face as she finger painted in her ICU bed and got paint everywhere.

Last year I attended a local conference sponsored by the NH State Council on the Arts and met some amazing individuals and learned about some local grant opportunities. With this newfound knowledge, I returned to work and partnered with our Child Life team to write a grant for a Music and Art Program (MAP) for our inpatient Pediatric Units. The first goal of the grant was to improve patient’s experience by providing interactive modalities (art and music) to hospitalized patients and their families. Our second goal was to expand the knowledge among healthcare workers regarding arts and music and its affect on the healing journey. After the grant was accepted, we eagerly started building the program. We connected with a very talented local musician whom also had an array of experience in working in a healthcare setting and we were also fortunate to connect with the Currier Museum of Science, to help us find a local artist. MAP ran over a eight week period of time, and received the highest ranking of “strongly agree” on the evaluations forms from both patients/families and staff alike. In the categories of this session was ‘comforting’, ‘beneficial to healing’ and ‘uplifting’ received the highest possible scores. Qualitative feedback from patients/parents gave us further insight on integrative modalities and the true meaning of their presence. One mother stated “doing art brought her out of her sickness shell,” while a patient stated “the music sends my mind somewhere else besides what is going on around me.”

The successful response to the MAP program has allowed us to explore sustainability of these services. We

recently contracted with the Manchester Music School to have a certified music therapist 12 hours a week and we are currently exploring funding to extend the local artist.

As healthcare providers, we all know that hospitalization can result not only in physical stress but emotional stress as well that comes from unexpected news, unfamiliar environments, inability to conduct normal activities and lack of control. Music and art on our Pediatric units has helped provide patients and families a familiar and positive way to cope with their hospitalization.

Whether providing direct care at the bedside or as a nursing leader, it is important to advocate for programs that truly make a difference for patients/families and staff alike. The MAP program is an example of an integrative program that combines the arts and science of healing and more importantly it continues to allow kids to be kids, even when they are sick!

Page 6 • New Hampshire Nursing News April, May, June 2014

in my oPinion

On Elevator Speeches

Sue Fetzer, NH Nursing News Editor

Imagine you were in a hotel and about to get on an elevator to the 30th floor. Getting into the elevator is a very important person you know, but not a nurse. You really want to convince her of the value of nursing and engage her support for your new nursing project. What do you say?

The elevator speech was used in the early days of the internet when companies needed venture capital and the competition was fierce. The best salespeople were those that could explain the business proposition to the occupants of an elevator in the time it took them to ride to their floor. An elevator speech that worked was able to describe and sell an idea in 30 seconds or less.

I recently had the opportunity to listen to a guru in the health policy arena, Dr. Lucian Leape. Dr. Leape has had two careers, the first as an expert Boston general and thoracic surgeon and then as an expert in quality health care. Dr. Leape was a member of the Institute of Medicine’s Quality of Care in America Committee, which published To Err Is Human: Building a Safer Health System (1999) and Crossing the Quality Chasm (2001). Leape believes that health care quality is about a problem of disrespectful behavior. Disrespect can take on three appearances: overt, covert and institutionalized. Overt disrespect includes behaviors aimed at humiliating, serve to be dismissive and are degrading. Every hospital and facility has a disruptive physician, according to Leape. Covert disrespect typifies individuals who are chronically late, won’t follow protocols, poor team players and often the major reason why a quality improvement project fails. The third appearance of disrespect is found in institutionalized norms related to employees and patients. Leape believes disrespect is present when employees are not free to talk about mistakes. Employees do not respect patients when there is no shared decision making, failure to inform, waiting for care and lack of common courtesies.

The last time I went grocery shopping, the clerk asked me at check-out if I had found everything I needed. How often do we ask patients if they have all the information they needed? As I was leaving, the clerk said “Thank you for shopping at _XXX, have a nice day.” When was the last time you heard a nurse or physician thanking a patient or their family? Where are the common courtesies in health care?

You are probably wondering if I happened to talk to Leape in an elevator; no, I did not have that opportunity. But what if I had or what if you had? What would your elevator speech about nursing be? We can no longer say that nurses provide caring, as a lot of other health care professions emphasize that they care too. We can no longer say that we do for the patient what they would do if they could; that has also become the pervue of the family of an outpatient too. It is really all about quality. And quality is really all about not being disrespectful and providing a service safely.

My elevator speech: I am a nurse and I provide quality health services that seek to ensure your safety while in my care. And I still have 29 floors to go....

Brenda K. Burke, MS, APRN, PMHCNS-BC

I had a physical recently. The experience from the moment I stepped into the office was memorable but for all the wrong reasons.

As I sat in the waiting room, a young woman wearing cartoon character scrubs and a hairpiece of hot pink and purple feathers called my name. I am not talking about a small barrette; a good-sized bird donated its plumage for this fashion piece. She did not introduce herself nor was she wearing a name badge. I wish that she had remembered that a badge is part of her uniform and that it helps identify her and her role in the office. I also wondered if any of the professionals in the office felt her hairpiece was inappropriate? If they did, why didn’t they say something to her? It could have been an opportunity to teach about the importance of dressing for the role. But then, again, what role? Who was this unidentified person?

The woman asked for my date of birth and then told me to get on the scale. In the short time since we’d met…all of one minute…she knew how old I was, how tall I was and how much I weighed. I, on the other hand, only knew that she liked pink and purple feathers. I didn’t know her name or what her role was and felt annoyed that if I wanted to know this information, I would have to ask for it. (I did ask her name and role and she said she was a medical assistant.)

She took my blood pressure with the standard size cuff placed over a long sleeved sweater. A larger cuff should have been used for accuracy. Also, the cuff and stethoscope should not have been placed over my clothing nor should my arm have been allowed to dangle without support. The mercury dropped like a severed elevator cable, much too fast to provide an accurate assessment. Since I take a medication for high blood pressure, an incorrect reading could affect future medication dosing. Why, if this is such an important assessment, is it the responsibility of a non-professional who uses poor form? I was losing confidence.

I have had a lot of annual physicals and this was the first time I was not offered a gown to change into. The physician performed the physical with me fully clothed. If there is some new protocol about how physicals are being done, I am not aware of it. My abdomen was not palpated and my yearly visit to a dermatologist and gynecologist must have been the reason my skin and breasts were not assessed. I have had basal and squamous cell skin cancer, and my deceased mother had a mastectomy for breast cancer. Would the redundancy of checking these organs have been a waste of time?

I was told that the “nurse” would come in to give me my flu shot. However, it was another medical assistant. She expressed a good portion of the vaccine from the syringe into the air…not just a tiny drop…a full arc of fluid and then some. How many patients would be inadequately immunized or be at risk this winter if she used this careless technique with them? I had good reason to be concerned. I was also concerned that the physician misrepresented a non-professional as a nurse. Clearly, I know the difference but I wonder if the average person realizes this professional role designation is being assigned to those not registered or licensed in the profession of nursing. No one attempted to clarify her role until I questioned it.

A third medical assistant came in to do my cardiogram (ECG). She opened my blouse and left my breasts and abdomen fully exposed. She pressed a bit too hard on my chest with one of the electrodes and I let out an “ouch.” Mockingly she asked, “Did that hurt?” When I replied “yes” she commented, “ You have a hostile tone.” I politely took the opportunity to point out that she may not be privy to patient problems that could contribute to an increased pain response, and, by the way, using the word “hostile” to describe a 10 second verbal exchange was, well, confrontational. She never said she was sorry for hurting me but mumbled that she could sometimes be sarcastic. I left it at that.

I am enormously proud of the nurses with whom I have worked and of those I’ve had the pleasure of teaching but, regrettably, no registered nurses had any part in my care. In fact, there are only a few professional nurses working in this large practice of over a dozen physicians. This is no accident. It is a move to cut costs but at whose expense? Unfortunately, this under representation of professional nurses is a growing trend, which I believe contributes to a decreased standard of care. My recent personal experience underscores this point.

It is the responsibility of those providing our care to inform us of their appropriate title and to strive for excellence in that capacity. It is our responsibility as patients to offer truthful, relevant feedback about that care. With that in mind, I made an appointment with my physician expressly to discuss my office experience. He listened attentively. I gave him a copy of this essay and asked him to read it when he had the time to reflect on it. I suggested he ask himself the question that has been haunting me – am I in the right practice? It has been months since our meeting and I haven’t heard from him. I think I have my answer.

Brenda Burke is an advanced practice nurse with an independent primary care practice in Salem, New Hampshire.

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April, May, June 2014 New Hampshire Nursing News • Page 7

Board of Nursing News

Denise M. Nies, MSN, RN, BCExecutive Director

The NH Board of Nursing has moved to the Philbrook Building located at 121 S. Fruit Street. The building is referred to as the Office of Professional Licensing and houses many of the licensing entities in the state. The nursing board office is located in the one story building and has an entrance separate from the main entrance of Philbrook.

Efforts by the Board of Nursing have been focused recently on rule edits and on emergency suspension of license hearings. Nursing Chapters 100, 400, 700, and 800 will be brought before the Joint Legislative Committee on Administrative Rules this spring. Work on Chapter 300 and 600 is ongoing for this year.

To date, the BON has had over 30 hearings. The focus statewide on drug diversion has led the Attorney General’s office to require the health professions that license to report all investigations that result in the complaints of drug diversion or impairment.

We have added another board staff person to the office. Anita Pavlidis, MS, RN has joined us as a Program Specialist for oversight of educational programs approved by the board. Anita’s experience serving in the faculty role and the department chair role as well as work as an NLN accreditor provides the board with expertise needed to manage program approvals. We are fortunate to have this resource!

The NH Board of Nursing Newsletter is available on our website at www.nh.gov/nursing under forms and publications. We publish a newsletter twice a year, once in the spring and again the fall. Please check the website for that and other resource information.

As we make our way through this very cold and snowy winter, please stay warm and practice safely!

Board phone number: 603-271-2323

What happens when a disaster strikes? What would happen if it hit New Hampshire? Did you ever think about helping out in a disaster?

The disaster health services response by the American Red Cross in New Hampshire is provided within a nurse-led model of care, using licensure/certification and scope of practice in a community setting. Red Cross Nurses provide services to individuals and families who lived at home prior to large disaster events, as well as help chapters respond to client needs for local disasters such as multi-family fires. Red Cross Nurses also work in collaboration with external health partners such as the medical Reserve Corps and local health departments. Since 9/11 occurred on our soil, more than ever the need for nurse volunteers is essential to help others in need.

Please consider, joining the thousands of other nurses who are making a real difference. Individuals, families and communities need YOU to assist them in being prepared and to help keep and promote health and safety! Those who depend on the American Red Cross in a crisis need nurses now. In NH our goal is to Recruit, Receive, Retain, and Recognize Nursing and other Health Professionals. The NH Chapter of the American Red Cross needs you if you are retired, semi-retired or even working full or part time.

We will find a convenient time and place for you! Please email Georgette Shapiro, RN, MS, at georgette.shapiro@comcast.net

Georgette Shapiro, RN MS is the Regional Nurse Liaison (RNL) for the NH Chapter of the American Red Cross. She serves on the NH Board of the American Red Cross and is a member of the New Hampshire Nurse’s Association.

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Page 8 • New Hampshire Nursing News April, May, June 2014

by Holly Clayton RN, MSNAssociate Editor

Hand Hygiene Reminders: 100 years ago

With an interest in history, I read a copy of a booklet entitled “The Trained Nurse and Hospital Review,” published in November, 1919. It provides a “snapshot” in nursing affairs nearly 100 years ago. Many advertisements are interspersed throughout, including burn dressings with plastic wax, early Dakins antiseptic solutions and various products claiming to treat multiple diagnoses. Upon reviewing it further, an article in the “Gleanings” section, entitled “Clean Hands – Dirty Hands are Dangerous” caught my attention. The article stated that soap and water should be used to clean hands, as human hands could spread disease. Handshaking was discouraged, and “medical men are pretty generally agreed that the infection of influenza is often conveyed this way” (“The Trained Nurse,” 1919, p. 341). The source was noted as “Bulletin – Chicago School of Sanitary Instruction.” This bulletin disseminated information from the Chicago Department of Public Health.

This volume was printed in the year following the onset of the pandemic influenza of 1918, infecting more than one quarter of the U.S. population and unknown numbers throughout the world. This Chicago bulletin was an educational tool. By including it in this nursing publication, the message was disseminated to a larger nursing audience. Thus, in this nursing publication, we see the attempts to prevent the spread of disease through improved hand hygiene through the printed word. A “reminder message” appears as the title: “Clean Hands – Dirty Hands are Dangerous.” It notable that, in the same journal, we learn of plans for preparatory staff education. Patient care courses were to be provided that month in Illinois State Hospitals “that had medical and nursing organizations,” in preparation for the “feared recurrence of influenza” (“The Trained Nurse,” 1919, p. 341).

Current Hospital National Patient Safety Goal: Hand Hygiene

Nearly 100 years later, we note hand hygiene continues to remain in focus – it presently remains a hospital patient safety goal. A review of Boyce and Pittet’s (2002) hand hygiene guidelines and recommendations at the start of this millennium revealed reports of healthcare worker compliance with hand hygiene as 15 – 80 %, with an overall average of 40 per cent. The authors also reviewed a study which showed wide variation in the number of hand hygiene episodes per healthcare worker in a time period (such as a “shift”). The range was 5 episodes/shift to greater than 100 episodes per shift (Boyce and Pittet, 2002). Noting that due to the varying definition of a “shift,” it was difficult to draw conclusions, but 5 hand hygiene episodes in an 8 hour shift was worrisome!

The January, 2014 volume of the official journal of the American Nurses Association, “American Nurse

Today,” includes an article entitled “Healthcare Reform: Resolve to Increase Your Knowledge in 2014.” Author Ewoldt encourages nurses to review the literature for best practices and seek opportunities for quality improvement with their colleagues and leaders. With this in mind, I reviewed the Joint Commission’s Hospital National Patient Safety goals (www.jointcommission.org), January 1, 2014. The following is the goal for Hand Hygiene:

Goal 7: Reduce the risk of health care-associated infections.

NSPG.07.01.01 Comply with either the current Centers for Disease Control and Prevention (CDC) hand hygiene guidelines or the current World Health Organization (WHO) hand hygiene guidelines “(retrieved from www.jointcommission.org).

The rationale for NSPG.07.01.01 is stated as: “according to the Centers for Disease Control and Prevention, each year millions of people acquire an infection while receiving care, treatment, and services in a health care organization. Consequently, health care-associated infections (HAIs) are a patient safety issue affecting all types of health care organizations. One of the most important ways to address HAIs is by improving the hand hygiene of health care staff” (retrieved from www.jointcommission.org). This section then discusses compliance with the World Health Organization (WHO) and Center for Disease Control (CDC) hand hygiene guidelines. Further details about comprehensive hand hygiene compliance program strategies are provided on the website. I reviewed the WHO and CDC websites as next steps.

Hand hygiene as a patient safety goal was discussed in the most recent edition of NHNA’s Nursing News (Jan. 2014), in the “Ask Flo” section. As stated in the column, hand hygiene compliance is a safety action to potentially improve patient outcomes. The use of “undercover observers” to audit compliance (with feedback to staff), and measures to prevent the spread of microorganisms adopted by some institutions were shared in “Flo”s discussion. Flo discussed visual barrier reminders with red tape and the “red line rule.” These, and other strategies, such as visual reminder tools (including screensaver reminders), inservices, bulletins, articles, travelling educational carts, the use of “glo lamps” with “glitterbug gel” for education, “scripting” (preparing staff to approach colleagues regarding hand hygiene), journal clubs, workshops, unit champion groups and mentoring can be used to educate and reinforce hand hygiene strategies. The cdc.gov website includes discussion on hand hygiene promotion methods and best practices within the “CDC MMWR: Guideline for Hand Hygiene in Health-Care Settings” section.

Reminder Tools

According to the CDC.gov website, “reminders” in the workplace play an important role in hand hygiene compliance because they serve as “prompts.” They remind us about practicing hand hygiene and help us teach patients and visitors about hand hygiene standards and expectations. “Reminder tools,” such as a posters or brochures in patient care areas can reinforce the hand hygiene messages. Patients can become partners in their

care with such tools. The CDC and WHO sites both include information on printable hand hygiene reminder tools. For example, www.cdc.gov/handhygiene?Resources.html includes resources in English and Spanish for patients and healthcare personnel. The website http://www.who.int/gpsc/5may/tools/en/index.html includes posters that can be downloaded on topics including “Your 5 Moments for Hand Hygiene, How to Handrub and How to Handwash,” as well as an educational video. These sites contain further information on the process. Additional tools, such as screensavers, a Patient Admission video and a handwashing dance video are included on these sites.

We have a wealth of “reminder tools” available to us, and note that such reminders can be created in different forms. In one institution, children created reminder signs to post and place within a hand hygiene workgroup website. “Reminder tools” can also appear in many sizes – from bulletins to posters to billboards. A while ago, I noted a memorable “reminder tool:” a billboard along a roadside, reminding mothers in that geographical area of proper baby diaper disposal, followed by hand washing. It had a printed message and large visual (picture). The message was clearly provided.

This article provided a “snapshot” of a hand hygiene message nearly 100 years ago, at the time of an influenza epidemic, and how it continues to remain in in the forefront today. The tools have expanded, yet the message from nearly 100 years ago remains the same “Clean Hands – Dirty Hands are Dangerous.” Many “reminder tools” are available to New Hampshire nurses - I invite you to take a look!

ReferencesBoyce J. & Pittet, D. (2002, October). Guideline for Hand

Hygiene in Health-Care Settings: Recommendations of the Healthcare Infection Control Practices Advisory Committee and HICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force. Retrieved from December 2, 2009 from http://www.cdc.gov/mmwr/PDF/rr/rr5116.pdf

Ewoldt, L. (2014). Healthcare reform: revolve to increase your knowledge in 2014. American Nurse Today 9 (1), 8-11.

(2014) Ask Flo in Nursing News, 38 (1): 13.Chicago School of Sanitary Health (1919). Clean hands –dirty

hands are dangerous (1919) The Trained Nurse and Hospital Review., LXIII (5), 341.

Resources:http://www.cdc.govhttp://www.jointcommission.orghttp://www.who.int

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April, May, June 2014 New Hampshire Nursing News • Page 9

“Mentoring is a brain to pick, an ear to listen, and a push in the right direction.” - John Crosby

Deborah McCarter-Spaulding, PhD, RN, IBCLC, WHNP-BC

My professional life (and for that matter, my personal life) has been rich with mentors. Sometimes they have been formal, such as faculty advisors, preceptors or colleagues whose designated role was to guide me in a new job or a new role. Others have been less formal, and perhaps could be more aptly defined as role models. The precise definition of a mentor is sometimes disputed, but it certainly includes a relationship in which one is advised and supported in their development.

I could tell you many stories of what I have been given by these mentors (just buy me a cappuccino and I’ll tell you stories) but I’ll share a more recent experience. As a newly minted PhD, I was beginning my first tenure-track faculty appointment. I was a very experienced nurse, and even had some experience with teaching classroom and clinical, but was completely new to the life of the academic faculty role, which would include research as well as teaching and service. I had the privilege of participating in a formal mentoring relationship with a seasoned faculty member, researcher and author through the National League for Nursing’s Faculty Mentoring Program (supported by a Johnson and Johnson grant). We had been matched based on my goals and her expertise.

What a gift! We only met face to face about 3 times during the year, but we had phone conversations, regular emails and phone conferences with 4 other mentor-mentee pairs in the same program. She asked me to define my goals, and then very clearly made suggestions as to what should be my priorities…basically she pushed me to get manuscripts submitted for publication from my dissertation research before I did or got involved in another things! Because I reported to her regularly as part of the year-long program, I was helped to stay focused on my goals. She even read my manuscripts and advised me to what journal I should submit. She was very supportive of me personally, but not in the role of a counselor dealing with emotional issues. She and I knew where I wanted to go, and our mutual goal was to get me there, and she knew the steps to take.

The program lasted only a year, but I have continued to have a relationship with her. I have sent her manuscripts, called her to bounce off ideas for research studies and

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The Gift of Mentoringeven vented to her via email of my frustrations with journal editors. It is no longer formal, but no less helpful. I know she believes in my ability to meet my goals and is committed to helping me get there. She has years of experience from which to draw, and freely offers me her help. As she is outside my workplace, and even my geographic area, I can speak freely and she can be completely objective. I feel it is my privilege to try to provide such support to others when I am able.

I have had other mentors in clinical settings, who helped me understand the challenges of developing expertise and deal with fears of incompetence or failure. They have shared with me what helped them. Some have helped me to connect with other nurses who could help me, and facilitated those relationships. They have recommended roles I could consider (such a membership in a task force) or goals I should pursue (such as advancing in the clinical nurse ladder) or places I could look to for support (such as applying for a grant or award). As I took steps toward meeting my goals, they encouraged me and supported me practically with resources and letters of reference. One of my clinical mentors keeps a whole computer file on me because I have asked for so many references over the years! Many of these nurses have worked with me, and with intimate knowledge of the environment have also

White Mountains CC Nursing to Restructure

The Board of Nursing, concerned about the falling NCLEX pass rates reported by White Mountains Community College, has placed the nursing program on conditional approval. According to the Board web site, 75% of the WMCC students passed in 2012 with a drop to a 67.7% pass rate in 2013. The average NH pass rate for these years was 90.1% and 91.1% respectively. In November, 2013 the college announced the associate nursing degree program would not accept a new class of nursing students in the fall of 2014 as it restructures the program to respond to concerns raised by the N.H. Board of Nursing.

White Mountains became the second nursing program to be placed on conditional approval by the Board of Nursing in 2013. The Board of Nursing voiced concern over River Valley CC earlier in the year. While 86% of the students at River Valley CC continue to succeed at NCLEX for 2012 and 2013, the loss of national accreditation placed the nursing department on notice. After losing its accreditation, River Valley voluntarily suspended classes for first-year nursing students, so it does have a freshman class this year. But current students are still eligible to take the licensing exam and new students are scheduled to be admitted for fall 2014.

taught me how to navigate the system. Others have been far away with the more dispassionate view of the situation.

What I know for certain is that I have been given great gifts by the generous commitment of these women, unselfishly contributing to my professional growth. They gave their time and their talent without asking for reward. As I have experience now with passing on what I have learned, I can see now that the reward is watching another grow and use their own gifts for the nursing profession. I have had former students grow well beyond me in their clinical skills or accomplishments, but there is much satisfaction in that. There is more than enough room in nursing for individuals who develop skills and expertise to share with their patients and pass on to colleagues. All of us have both knowledge to gain and knowledge to share. I believe it is our responsibility as nurses, as well as our great honor, to participate in mentoring and being mentored.

Page 10 • New Hampshire Nursing News April, May, June 2014

April, May, June 2014 New Hampshire Nursing News • Page 11

Page 12 • New Hampshire Nursing News April, May, June 2014

Leadership Changes

Karen Richards, DNP, RN, NE-BC, joined the Elliot Health System in November, 2013 as the Executive Director, Professional Practice and Magnet Program. Richards was formerly at Exeter Hospital as their Program Director for Magnet and the Advancement of Nursing Practice. Richards received her DNP from Case Western Reserve in 2009.

Walter Szuksta, RN, BSN, CNOR, joined the Elliot Health System in November, 2013 as the Director of Surgical Services. Walter was formerly at Lowell General Hospital as their Clinical Manager of the Operating Room and Central Sterile Processing. Szuksta received his BSN from Chamberlin College in 2012.

Patricia Shinn, RN, PhD, has assumed the Chair of River Valley Community College nursing department. Shinn was an associate professor at SUNY-Canton from 2007-2013 and received her PhD from Walden University in 2013. She also previously worked as the director of nursing at Clinton Community College in Plattsburg, N.Y.

Theresa Woolbert, RN, BSN, has been appointed director of Nursing at Maplewood Nursing Home. She has been the assistant director of nursing at Maplewood since 2008. Woolbert began her nursing career in long-term care in 1988, received her LPN in 1992 and her Associate Degree in Nursing) in 1994. While working in long-term care and home health, she studied and received a Bachelor of Science in Nursing in 2006, from the University of Phoenix.

Ed Note: On November 8, 2013, super typhoon Haiyan or “Yolanda” hit the Phillipines as the strongest storm ever reported to make landfall and the deadliest recorded in the Philippines. Initial estimated deaths reached 10,000 only a few days after the storm. The country suffered catastrophic damage that crippled the entire government. Places severely affected were the cities of Tacloban, Palo and Tanauan. Some described the destruction as apocalyptic in scale; with roughly 90% of the cities mentioned flattened to the ground by the winds and washed away by the 20 foot storm surge. As of January, 2014, bodies are still being found. Lakes Region General Hospital nurse, Don Valles recounts his story as he flew to back to his native country.

The plan to go home to the Philippines started after watching CNN and seeing the extent of the devastation of the typhoon. Years ago when I was in the Philippines, I worked as a health care provider assigned to a rural area. There, I dealt with outpatient and emergency cases and I was familiar with the local diseases. I spoke the dialect so this gave me confidence that I would be effective in helping my fellowmen during this time of need. I spoke with my best friend in medical school, now a practicing physician in Australia, who was also planning to go home. In fact, he already made arrangements with a local group that would be able to fly him to Tacloban, and he said that he would be able to get me in with the group. The next day, I made arrangements to make sure that I could take some time off to help out with the devastation. Three days later, I was on a plane to the Philippines, despite the uncertainties regarding safety and security, food and accommodations and even the physical possibility of flying to the Tacloban airport, which was wiped out by the storm surge.

After a long 21-hour flight, I arrived in Manila at midnight on November 15, where I met up with my friend Earl. The next day we had a briefing with the rest of the team – we were composed of three physicians and three nurses. We were advised to expect the worst and be self-sufficient. We were then shuttled to the airport in Manila and, because of the inability of the Tacloban airport to accommodate all the incoming flights; we were redirected to Cebu to fly on a military plane to Tacloban. Early morning on the next day, we arrived in Tacloban, where we had to register with the United Nations so they could keep track of the number of medical personnel.

The devastation I saw on television was nothing compared to the images that were before me. It looked like a war zone. The survivors looked dazed and confused walking on the streets, trying to salvage what was left of their belongings. Some were still looking for their loved ones and relatives. We saw military personnel with full gear manning the streets, trying to keep a semblance of peace and order. The stench of decomposing dead bodies was very disturbing. The usual 10 minute drive to the hospital became an hour and a half long due to the debris of flattened houses, building, cars, and felled trees cluttering the road.

Arriving at the Remedios Romualdez Hospital, we saw that even a hospital built to withstand strong typhoons was not spared. The hospital’s roof was blown away, and there was no electricity so a small generator was running the hospital. The operating room and the delivery room were non functional, and there was no inpatient care. The whole hospital was endorsed to our care after the first group of physicians left, having manned it for 6 straight days. When we opened the hospital the next day, patients came in by the droves. We saw cases in the ER like severely infected wounds needing debridement, tetanus with opisthotonus, sepsis, and anuric patient for 4 days needing foley catheterization, status asthmaticus, and premature labor. All patients needing inpatient care were referred to another hospital that was not as badly damaged.

We saw around 240 patients on our first day, with the help of another Hungarian medical team. On our second day, as other medical teams started arriving (from Harvard University, Switzerland, Taipei and Lebanon), our team was deployed to the city of Palo, just 15 miles away from the hospital, because there were still some areas that had not received medical care. We provided outpatient care, with the bulk of patients needing wound care. Most of these wounds were seen and treated a week prior and the patients were only given antibiotic regimens for two days due to lack of medicines. They had no follow-up dressings due to the lack of supplies. Several cases of diarrhea were also seen, due to poor sanitation and a lack of water supply. Cough and colds, worse in young children, were noted due to crowded evacuation centers and poor living conditions. Chronic diseases such as hypertension, diabetes were poorly managed due to the lack of or absent resources. We saw patients on a makeshift portable clinic from 9 AM to 5 PM, then we would go back to the hospital where we were housed, and took turns seeing patients in the ER all night. We would wake up early next morning to prepare the supplies and medicine needed later that day. The third and fourth days were also spent providing outpatient care to other remote areas. By then, medical volunteers from around the world had started arriving along with the relief goods. By the fifth day, medical volunteers already covered most of the places, so we decided to fly back to Manila.

The whole experience was an eye opener for me. It was very hard coming back to the US, seeing people cheerful, busily shopping and preparing for their Christmas dinners. My co-workers singing Christmas songs literally made me cry just thinking about the people left behind in the Philippines with no food to eat, no blanket to keep them warm, no portable water and no roof to give them shelter. But life goes on. I learned many things with this trip and with the experience. One of those things is that this only marks the beginning of my journey to help my native countrymen and women.

Cirilo Roy ‘Don’ Valles, RN, received his nursing education from Arriesgado College Foundation in Tagum, Philippines and has practiced at Lakes Regional General in the cardiac telemetry department for the past six years.

NH Nurse Aids Typhoon VictimsPhotos courtesy of: Argel Erfe, RN

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April, May, June 2014 New Hampshire Nursing News • Page 13

NH Nurses on the National Stage

Cy nth ia Cohen , M S N , C N L , CCRN, RNC, and Nicola Levasseur, RN, MSN, CNL, presented “Dedicated P u r p o s e f u l Rounding” at the Clinical Nurse Leader Summit in Anaheim, C a l i fo r n i a . T h e presentation focused on the creation and i m p l e m e n t a t i o n of The additional specialized LNA role of Designated Purposeful Rounder recently added to the staffing matrix at Elliot Hospital. The Dedicated Purposeful Rounder is responsible for rounding hourly on the entire unit with a focus on patient safety, exceptional customer service, and increasing patient mobility and function.

New Hampshire nurses were well represented at the recent 2014 ANA Quality Conference held in sunny Phoenix, Arizona. Over 1,000 nurses from all over the country and the world attended the three day conference to learn of the newest trends in quality health care. Three poster presentations were authored and presented by New Hampshire nurses.

Tom Szopa, MS, RN, CWON, CCCN, Patient Care Manager at the Elliot Hospital, presented “Weekly I n t e r d i s c i p l i n a r y Skin Rounds in a Community Hospital: Preventing Pressure Ulcers, Improving Care.” Skin Rounds occurs weekly at the same day and time, and proceeds through two medical-surgical units; the Pediatric and Adult Intensive Care Units and the Gero-Psychiatric Unit. During rounds, a provider assists caregivers to assess the patient’s skin, clarify the skin condition, stage a pressure ulcer if necessary, assess current interventions, offer recommendations for additional care, and provide education for staff, the patient and family. In addition to increasing staff knowledge of skin care NDNQI pressure ulcer prevalence data found a zero prevalence of skin ulcers for 3 quarters following the implementation of Skin Rounds.

Nicole Young, RN-BC, AD, presented a poster titled “Iron Infusion Protocol: I m p a c t o f Un i t B a s e d P r a c t i c e . Young is a staff nurse at Southern N ew H a m p s h i r e Medical Center and chairperson of the Unit Based Practice Committee. The iron infusion protocol was developed as a result of staff lack of knowledge and need for consistency in caring for patients requiring iron infusions. After a literature review and benchmarking best practices, the Committee, under Young’s leadership developed the protocol, educated staff and audited patient records for compliance. Staff knowledge increased and resulted 100% compliance with patient care.

Sue Fetzer, RN, PhD, Director of Nursing Research at Southern New Hampshire Medical Center, presented a poster titled “Nurse Perceptions of Strategies to increase NDNQI Survey Participation.” After noting a continual positive increase in staff participation with NDNQI survey, Fetzer surveyed the staff inquiring as to what was the most convincing strategy encouraging survey completion. Key messages that encouraged staff participation were related to professional pride, autonomy and accountability.

Ask fLo...Ask Flo is designed to answer questions about practice, education, administration or employment. Send your questions to Ask Flo c/o NHNA Nursing News. All questions will be printed anonymously.

Dear Flo,I just took a job as the evening charge nurse on a long term care unit. Recently one of the medication nurses directed the medication nursing assistant (MNA) to medicate one of the residents. The medication was for pain and was a narcotic. I did not think MNA’s had this authority? What should I do?Signed, LTC Novice

Dear LTC Nurse,You are right to be concerned about this practice. According to the NH Nurse Practice Act, MNA’s are only to administer medications to “stable” clients. The definition of stable, according to the Board of Nursing is ““a client whose health status is under control and raises no expectation that the client’s symptoms, vital signs, or reactions to medications will suddenly change.” A patient in pain is not included in this definition. As nearly all narcotics will change symptoms or vital signs, the delegation of this activity by the nurse was inappropriate.

I would suggest you review the role and responsibilities of the MNA job title with all of your staff during the next staff meeting. A review of the rights of delegation may be also needed. Flo

Dear Flo,I am an over 50 RN and on a recent visit to my health care provider it was suggested that I consider getting the shingles vaccine. I remember getting a bad case of chicken pox when I was a teenager, so what good will the shingles vaccine do?Signed, Chicken

Dear 50+,The varicella zoster virus was the cause of your chicken pox. The first exposure is usually a mild disease of childhood, though adults are not immune. While your body has developed antibodies against the infection, the virus is still in your body. It is a sneaky virus, hiding dormant and inactive in your peripheral nerves. If it becomes active, shingles develop. While the painful rash and blisters will heal in 2 – 4 weeks, 20% of individuals with shingles will experience long term postherptic neuralgia or PHN. PHN is a severe nerve pain that can last for years after the blisters have resolved.

The vaccine is a weakened form of varicella that allows your body to build up the antibodies. The vaccine reduces the risk of getting shingles by 50% and reduces the duration of PHN. You won’t get the chicken pox again. The CDC recommends that all adults 60 and over receive the shingles vaccine. Don’t be a chicken!Flo

IF YOU HAVE A QUESTION FOR FLO – send an email to office@nhnurses.org

For a more immediate response than this quarterly paper provides – don’t forget to seek help from our volunteer MENTORS via http://nhna.moodlehub.com

On the Bookshelf

Reviewed by Alex Armitage, MS, CNL, APRN-BC, FNP

Alexandra Armitage is a Nurse Practitioner and a certified Clinical Nurse Leader, specializing in neurology and neurosurgery; bringing evidence-based practice to the bedside to improve patient care, patient outcomes and institutional viability.

Whole Person Caring: An Interprofessional Model for Healing and WellnessLucia ThorntonSigma Theta Tau (2013)Paperback, 263 pages

It was Florence Nightingale who said that “We are a reflection of the divine, with physical metaphysical and intellectual attributes.” In Whole Person Caring: An Interprofessional Model for Healing and Wellness a model of patient care is explored that embraces holistic nursing practices in the care and wellbeing of patients and of the nurses involved in their care. It challenges nurses to bring their whole being to care for the patient. In the model of whole-person caring, caring for people is considered to be sacred work. “So beginning to perceive ourselves [the care takers] as sacred is the first step in this journey.”

The book opens with a chapter on shifting the focus of patient care to healing and wellness. This results in redefining who we are beyond just the biology of humanity, and in doing so the author integrates both the care giver and the patient into her model of healing and wellness. Self-compassion, self-care and self-healing are foundational to this outlook and self-care and self-healing practices are explored with the goal of optimal health and wellness. There is a chapter on therapeutic partnering and transformational leadership. Partnering involves patient self-empowerment as well as partnering with coworkers. She states that “Leadership within the model of whole-person caring is spiritually based and transformational in nature …. Leaders must learn to access their own spiritual … essence to be effective.”

Our Healthcare is moving towards integrated patient care, In Whole Person Caring the author supplies the tools healthcare professionals need to implement the model. The focus is on involving every aspect of patient care, physical, emotional, social and spiritual. I would recommend this as a broad general interest read and especially for those in academia or leadership positions.

Page 14 • New Hampshire Nursing News April, May, June 2014

Students and faculty from PSU in Costa Rica.

Face painting during our “sharing with the community” time.

Discharge and pharmacy at a clinic.

Dancing at the nursing home.

by: Sandra McBournie, BS, MEd, RN & Anne-Marie Cote, MS, RN

In January 2014, the Plymouth State University (PSU) Nursing Department hosted a clinical study abroad trip for senior nursing students to areas around San Jose, Costa Rica. Thirteen nursing students, accompanied by Professor Annie Cote and Professor Sandra McBournie, performed typical clinical duties while working with the non-profit non-governmental organization International Service Learning (ISL).

Alajuela is in the central northern valley region of Costa Rica, housing over 100,000 people. Two areas of the Alajuela region were visited by the PSU team. Sites visits were conducted to the impoverished districts of the region, including La Providencia (a city slum) and Fraijenes (a coffee farming community). Students went home-to-home knocking on doors and collected census data, which including the following assessments: access to potable water, sanitation in the homes and the presence of chronic illness of the residents. During these visits students were often welcomed into homes, and families revealed chief complaints needing medical attention during health history assessments.

Potential patients were invited to visit the “clinica gratis” or “free clinic” set up by our team within walking distance to the visited area. Frequently entire families representing all ages, from infancy to older adult, would come to the free clinic collectively. Often students found that each family member was afflicted with a different common ailments of the region, such as upper respiratory infections, skin diseases, parasites, and more. Students gained experience working with patients across the life span, in an unfamiliar culture, with various common diseases of the geographic area.

This trip additionally provided students with the opportunity to absorb the beauty of the people and the landscape of Costa Rica. One afternoon, students set up a recreation day, referred to by ISL as a “sharing with the community event.” It was held at the local church, and children could play games, have their hair braided, face painted, or nails done. At the same time, one student certified in massage did chair massage for the parents while the children enjoyed recreational activities. Another day, the group visited a local nursing home where conditions resembled a time gone by in long-term care in the United States. Restraints were used abundantly and there was one nurse present for more than 100 patients. The sadness of the venue was replaced by joy when our PSU nursing students insisted that residents dance to the music playing in the courtyard. The gratitude by participants at both the clinics and the recreational activities was palpable, despite language barriers.

Plymouth State University Nursing Clinical in Costa RicaISL assured students were well prepared for this experience by providing team members with a comprehensive manual and ample orientation period. Nursing students who participated in the trip received three academic credits toward their community clinical requirement for graduation. Students described the experience as life changing and reaffirming to their commitment to nursing. They additionally conveyed that this experience was an opportunity to apply all the psychomotor skills they had acquired thus far in nursing school, while challenging their critical thinking abilities. One student stated about the experience: “I fully believe that it has made us stronger as students, human beings, and medical professionals alike.”

While learning, personal fulfillment, and thought provoking moments were abound, the stress of the heavy workload and long hours was perpetually balanced by the joy and laughter of the group. Moments of laughter were often led by our gracious ISL team leaders, whose energy and enthusiasm for this work was paramount in setting a tone of collaboration and cohesiveness. Thank you to ISL for hosting us, the people of Costa Rica for their gracious attitude, PSU for supporting this academic endeavor, and to our stellar students for their hard work and dedication to this project.

For questions about the experience please contact Sandra McBournie at sjmcbournie@plymouth.edu or Ann-Marie Cote at acote3@plymouth.edu.

Read more about the student’s experience on their blog at http://psucostaricanursing.blogspot.com

Students during house visits in La Providencia accompanied by an ISL provided interpreter.

New HampshireHospital

Acute Psychiatric

Services

Full time openings for Psychiatric Registered Nurses

(RN I-III)on evening and night shifts. All nurses

receive extensive paid orientation for this specialty practice. View job

specifications, benefits package and how to apply at:

www.admin.state.nh.us/hr

CONTINUING NURSING EDUCATION

100 Saint Anselm DriveManchester, NH 03102

(603) 641-7086www.anselm.edu/cne

Committed to Promoting Excellencein the Practice of Nursing

NEW! Online programs now available.

Visit our website for an updated list of programs or call for a brochure

April, May, June 2014 New Hampshire Nursing News • Page 15

The New Hampshire Action Coalition (NHAC) was developed by and is supported by four organizations: New Hampshire Nurses Association, New Hampshire Organization of Nurse Leaders, Foundation for Healthy Communities, and New Hampshire AARP. The Action Coalition was formally established in February 2012 with a goal of implementing the recommendations of the Institute of Medicine report on the Future of Nursing, Advancing Health which are supported by the Robert Wood Johnson Foundation and AARP through the Center to Champion Nursing in America.

An important pillar in the national Campaign for Action is the Leadership Pillar. The Institute of Medicine Report, Future of Nursing, Advancing Health, identified:

“As leaders, nurses must act as full partners in redesign efforts, be accountable for their own contributions to delivering high-quality care, and work collaboratively with leaders from other health professions” (Institute of Medicine, 2010).

Nurses have a direct and critical impact on the quality and safety of patient care provided. In addition, nurses provide insight on the entire care delivery process, including patient and family involvement and staff satisfaction. Because of this, health care leaders, researchers, nurse leaders, regulatory leaders, and consumers have identified that more nurse leaders need to serve on boards to impact transforming health care. One strategy being pursued to achieve this is to develop collaborations between all health care leaders to increase the number of nurses serving on boards, including hospital, state, and federal decision making boards.

The Campaign for Action believes that if nurses want to guide health care system change, we must be prepared to serve in leadership positions, including governing boards. In order for this to be successful, we must all work to prepare more nurses to manage health systems and lead health care transformation. The Campaign for Action is working to position nurses as valued partners in health

care improvement. Part of this strategy is having each state level action coalition work on these leadership strategies within their own state.

As a way to accelerate this component of the campaign, the Center to Champion Nursing in American convened more than 35 Action Coalitions in a series of three meetings – in Seattle, St. Louis and New Orleans –to develop a national strategy to increase the number of nurse leaders serving on hospital system, state, and national boards. Action Coalitions and other guests also had the opportunity to share information on their current leadership programs and initiatives to develop nurse leaders for board appointments and other leadership positions. The three meetings were very exciting, productive and fun sessions that provided a venue for advancing the important work centered on preparing nurses to lead and transform health care. A key objective of the meetings was to develop an understanding of the need for a shared national strategy to increase the number of nurse leaders serving on hospital/system, state, and federal boards.

Four representatives from New Hampshire attended the “Leadership in Action” meeting held in New Orleans on January 13/14. Linda von Reyn, New Hampshire Action Coalition co-lead representing the New Hampshire Organization of Nurse Leaders [NHONL] was accompanied by three colleagues who will work to establish a Leadership Pillar within the New Hampshire Action Coalition:• Trish Sweezy, NHONL President and Director of

Clinical Operations Ambulatory Practices, and Director of Care Coordination Elliot Health System

• Brian J. Pinelle, MSN, MBA, NEA-BC, NHONLSecretary and Assistant Vice President, Inpatient Services at Wentworth-Douglass Hospital

• Margaret Franckhauser, RN, MS, MPH, CEO ofCentral New Hampshire VNA & Hospice in Laconia New Hampshire

At the meeting in New Orleans, the NH work group developed a Leadership Strategic Action Plan as a way to launch this activity within New Hampshire. The Action Plan is currently comprised of the following components:• Establish Leadership Pillar workgroup within New

Hampshire in order to develop a critical mass of interested stakeholders

• Gather data on nurses working on Boards orinterested in leadership roles on Boards and governing bodies

New Hampshire Action Coalition Update

PERDIEM STAFF WANTEDFOR SNF, LTC & ASSISTED LIVING -

All ShiftsPrevious experience and flexible schedule a must!

Send resume and cover letter to:Webster at Rye Human Resources

795 Washington RoadRye, NH 03870

Or email toinfo@websteratrye.comPlease no calls/walk-ins.

CAMP NURSES—MAINE!

Maine girls’ camp seeks RNs for the summer, June 20-August 17. Salary, travel allowance,

room, board and laundry included.

Look us up: www.camptapawingo.comEmail us: jane@camptapawingo.com

Or call: 973-275-1139

BeautifulNHcampservinginner-cityandlow-incomeboysandgirlsseeksLPNorRN

from6/18-8/21.Responsibilities: health care, meds, first aid for 60

campers, 25 staff . Minutes from MD/hospital . Supportive environment . Private accommodations,

meals, children’s tuition, salary all included . Partial Summer positions may be available .

Contact Amy Willey at 603-924-3542 .www.brantwood.org

Nurses are vital to Camp Robin Hood! Camp Robin Hood is seeking qualified RNs, NPs, and advanced nursing students to join us in Freedom, New Hampshire this summer, 2014!

Camp Robin Hood is an overnight summer camp for around 350 boys and girls aged 7-16 years old. Our mission is to provide a nurturing environment in which lasting bonds are made.

We are looking for qualified individuals who are available to live at camp for the summer and must be willing to do on-call over night shifts. Room and board included.

Dates: June 24–August 14 (Dates are flexible)Salary: Based on experience • Requirements: CPR/AED/First Aid

If interested please send a copy of your resume to molli@camprobinhood.com

Camp Half Moon in the Berkshires—Camp Nurse positions available. RN, LPN. Beautiful lakefront setting with heated pool. Salary, room, board and travel—families welcome. Partial summer available. Season dates: June 18th-Aug. 17th. Must enjoy working with children in a camp setting. Day Camp & Sleepover Camp, coed, ages 3 to 16.

Write to P.O. Box 188Gt. Barrington, MA 01230

888-528-0940www.camphalfmoon.com

email: info@camphalfmoon.com

Wediko NH Summer ProgramWindsor, NH 7/5-8/18

Therapeutic Residential Summer Camp Program for Youth with Emotional, Behavioral, and Learning Issues seeks:

Registered NursesLicensed Practical Nurses

Positions available:day and evening shifts, overnight on-call.

Experience in school nursing or mental health nursing preferred. Competitive Salary, Flexible Scheduling.

POSITIVE work environment.

Send resume to: Wediko Children’s Services, c/o Noel O’Connor,

72 E. Dedham St., Boston, MA 02118;(617) 292-9200; noconnor@wediko.org.

• Survey organizations to determine who has nurseson boards or who are interested in having nurses on board.

• Develop curriculum or identify existing nursingleadership programs that could be developed into a “nursing leadership institute” with the goal of identifying and increasing the number of nursing leaders within the state

• InitiateconversationwithKeyStakeholderstoeducatethem on the national strategy and determine mutual goals

• Developmentofcommunicationplanwithin thestateto disseminate the national campaign

Sweezey and Pinelle will serve as leaders for this pillar within the Action Coalition. They have already convened a small workgroup of interested nurses and held an initial meeting. If you are interested in being involved in the work of the Leadership Pillar, contact Trish Sweezey (PSweezey@Elliot-HS.org) or Brian Pinelle (Brian.Pinelle@wdhospital.com).

If you would like additional information about the Campaign for Nursing and the New Hampshire Action Coalition, visit the Future of Nursing Campaign for Action at the Center to Champion Nursing in America http://campaignforaction.org/.

CAMP NURSES NEEDED

Page 16 • New Hampshire Nursing News April, May, June 2014

Elliot GradJoan M. Malloy, 80, died November 20, 2013. A 1953 graduate of the Elliot Hospital School of Nursing, she was employed at the Elliot and later in Boston Hospitals. She was a member of the Elliot Hospital Nurses Alumni Association and the American Red Cross, volunteering her services in nearly all the blood drives in Dover and Durham for many years.

Veterans’ NurseCharlotte C. (Hogan) Gavin, 66, died November 21, 2013. She was employed for 18 years as a licensed practical nurse by the Manchester VA Medical Center.

Nursed in 3 WarsHelen W. Collings, 93, passed away November 20, 2013. A native of Twin Mountain she graduated in 1941 the Massachusetts General School of Nursing in Boston. She entered the U.S. Army Nurse Corps as a 1st Lieutenant and served for 26 years retiring with the rank Major in 1967. Her awards included the American Campaign Medal and the World War II Victory Medal having served during WWII, the Korean War and the Vietnam War. Following her retirement she returned to her hometown of Littleton, N.H., and for nine years continued her nursing career as school nurse at Littleton High School.

St. A’s GradGeorgina E. “Georgie” Wuchter, 91, died November 22, 2013. A graduate of the Notre Dame Hospital School of Nursing, in 1957, she earned a bachelor of science degree in nursing from Saint Anselm College. She earned an MSA from Boston College in 1964 and a C.A.G.S. from Boston University in 1967. She practiced as a night nursing supervisor and operating room supervisor at Notre Dame Hospital and Catholic Medical Center. Until her retirement in 1987, she was a professor of nursing at Saint Anselm College. Upon retirement she served as a parish nurse at various Manchester churches. She was a longtime member of the NH Nurses Association, the American Nurses Association, and the NH Council of Catholic Nurses.

Berlin NativeBeverly (Blair) Penney, 79, died November 23, 2013. A lifelong resident of the Berlin-Gorham area in 1980, Beverly realized her lifelong ambition of becoming a nurse and graduated from the Berlin Vocational Technical College as a licensed practical nurse. She practiced at the Androscoggin Valley Hospital and for the St. Vincent de Paul Nursing Home in Berlin.

MDS CoordinatorGail L. Krzywicki, 62, died November 30, 2103. She was a graduate of the St. Joseph Hospital School of Nursing and NHTI in Concord. She practiced as an MDS coordinator for Courville Community in Nashua. She also had worked for Parkland Medical Center.

Native CanadianCarolyn Bess Scott Thibodeau, 77, died November 24, 2013. She received her Canadian nursing diploma in 1958 and spent the last 20 years of her career at the Rockingham County Nursing Home in New Hampshire.

Private Duty NurseElaine A. (Connolly) McCoy, 92, passed away December 15, 2013. A lifelong resident of Manchester she was a graduate of the Sacred Heart School of Nursing. In her early years, she was a private duty nurse. She was an active member of the Catholic Nurses Association.

Elliot NurseNancy Marie (DeAnglis) McCusker, 59, died December 17, 2013. She had practiced as a registered nurse at The Elliot Hospital in Manchester, until the time of her passing.

NHNA Nurse of YearJanet Eadie Small, died December 17, 2013. She graduated in 1939 from N.H. Hospital School of Nursing and went on to receive a Bachelor in Nursing and a Masters in Nursing Education from Boston University. She was employed at the NH Hospital for 47 years; serving for 32 years as the Director of the School of Nursing. She received many nursing awards and citations of merit. In 1979 she was the NHH Nurse of the Year for her leadership and dedication to the field of nursing. She was an active member of the American Nurses Association, National League of Nursing, and was a Council Member on the NH Board of Nursing.

Sacred Heart GradClaire T. Sanfason, 83, of Hooksett passed away on December 18, 2013. A Manchester native she was a graduate of Sacred Heart School of Nursing and remained to practice for 37 years Catholic Medical Center until her retirement.

LPNVirginia “Ginny” Barrett, 97, passed away December 23, 2013. She was an LPN for many years, working New London Hospital, Laconia State School, Lakes Region General Hospital, Tilton Veterans Home and the Tilton School. She served as a director of the Licensed Practical Nurses Association of N.H.

in memory of our CoLLeAgues

Joan Malloy

Elaine McCoy

Janet Small

Claire Sanfason

Virginia Barrett

Nancy McCusker

Charlotte Gavin

Helen Collings

Georgina Wuchter

Beverly Penney

In Memory continued on page 17

UNIVERSITY of NEW HAMPSHIREDEPARTMENT of NURSING “Preparing skilled, knowledgeable, reflective leaders in health care.”

Are you an RN?Do you have a bachelor degree that is not in Nursing?

Would you like to have your Master’s Degree in Nursing?

• Applications are now being accepted for the 31 credit Evidence Based Nursing Track in the Graduate Program of the Department of Nursing at UNH!

• Admissionrequirementscanbefoundatwww.unh.edu keyword “non-BSN”

• GraduatesofthisprogrammayapplytothePost-Master’sFamily Nurse Practitioner Certificate Program at UNH

Courses now enrolling to start Fall 2014

To learn more about advancing your career with a master’s degree in nursing, go to

www.chhs.unh.edu/nursing/graduate-programs

RN to BSN Program at Saint Anselm College

www.anselm.edu/bsn-today

Advance with Excellence in New Hampshire’s

Top Nursing Program.

•Online hybrid program •Rolling admission •Accelerated •Flexible

(603) 641-7334 nursing@anselm.edu

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April, May, June 2014 New Hampshire Nursing News • Page 17

Industrial NurseSonja (Davidson) Wilson, 75, died February 1, 2014. She was a diploma graduate of Concord Hospital School of Nursing and practiced as an industrial nursing until leaving to raise her family. She re-entered nursing after her children were grown, working until retirement at Greenbriar Nursing Home in Nashua.

CentenarianAnnie L. (Miles) Kucharski, 100, passed February 6, 2014, Annie graduated from the Exeter Hospital School of Nursing in 1935. She was a staff nurse in the hospital, and for many years was a nurse at the Exeter Clinic in Exeter.

Hospice NurseSusan M. Herrmann, 63, died February 9, 2014. She received a degree in nursing in Vermont and attended Keene State College and Antioch University in Keene, where she received a certification in community health and management. Her passion was educating the medical profession and the public about hospice and of allowing people to have a peaceful death at home. She was the director of hospice at Home Healthcare, Hospice and Community Services in Keene for 18 years. She received certifications from National Hospice and Palliative Care as a certified hospice and palliative care registered nurse and also in National Hospice and Palliative Care Leadership and Management. She was a member of the executive board of directors with State Hospice and Palliative Care.

St. Joes’ GradRena A. Couturier, 83, died on February 11, 2014. Born in Montreal, Canada she fulfilled a lifelong dream by pursuing a career in nursing, graduating as a licensed practical nurse at age 58 and working for several years at St. Joseph Hospital.

MHMH GradPatricia E. Smith, 92, passed away December 25, 2013. She was a graduate of the Mary Hitchcock Hospital School of Nursing and while her children were young, she served as a school nurse in Vermont.. Later, she served as a private duty nurse, a hospital floor nurse, and eventually a nursing supervisor at the Mary Hitchcock Memorial Hospital, until her retirement in the mid-1970s.

Active NHNA MemberMaureen Sullivan Bissonnette, 82, died on January 9, 2014. She graduated from Mount Saint Mary Sacred Heart Hospital School of Nursing and continued her education by attending St. Anselm College, receiving her Bachelor of Science degree in nursing. For many years, she was Vice President and Treasurer of District 5, NH State Nurses Association. She also served on the state level of the Nurses Financial Board. She was also the Treasurer of the Manchester Chapter of the Catholic Nurses Association.

Home Care DirectorMary Elizabeth (“Bess”) Hastings died on January 15th, 2014. She graduated from Columbia University in 1959 with a BS in Nursing. She began her career working as a registered nurse at Mary Hitchcock Memorial Hospital in Hanover, NH. Later, she worked as the Director of Home & Community Health Care of the Upper Valley in White River Jct., VT. Following a long career there, she worked to complete a merger of her agency with the consolidated VNA/VNH before retiring in 1996.

Psych NurseMary-Louise Comins Crozier, 77, died on January 17, 2014. A 1959 BSN graduate she began her career as a psychiatric nurse at McLean Hospital in Boston. She was a nursing instructor Burbank Hospital School of Nursing and director of a day treatment program for the mentally ill. She served as the nurse manager on an adult psychiatric unit at the former Brookside Hospital in Nashua and ended her 46 year career on the Access Team at SNHMC in 2006.

Rivier GradCarol (Roy) Tischner, passed on January 24, 2014. She received her bachelor’s degree in nursing and a master’s degree in theology from Rivier University. Her practice for many years in various hospitals and skilled nursing facilities, provided faith-filled care of the sick and disabled.

Office LPNSylvia (Panzieri) Nordle, 90, died January 27, 2014. She attended the Sacred Heart Hospital School of Nursing and later became a Licensed Practical Nurse. She worked as an LPN at Sacred Heart Hospital and several Manchester area doctor’s offices including Doctor’s Pilpil and Arambulo.

Sacred Heart GradElizabeth J. “Betty” (Rose) Lupien, 88, died January 28, 2014, She graduated from the Sacred Heart School of Nursing as a registered nurse and practiced there early in her career. Until her retirement, she did private duty nursing.

in memory of our CoLLeAgues

Mary Hastings

Silvia Nordle

Sonja Wilson

Patricia Smith

Maureen Bissonnette

Carol Tischner

Elizabeth Lupien

Susan Herrmann

In Memory continued from page 16

APRIL 6 – 12 is NATIONAL VOLUNTEER WEEK:JOIN MEDICAL RESERVE CORPS!

April6–12thisNationalVolunteerWeek! The Medical Reserve Corps would like to recognize and THANK all of our Volunteers who have helped the Greater Sullivan County region to stay healthy and safe . The Medical Reserve Corps is a Federally-based volunteer organization, under the Office of the U .S . Surgeon General; our mission is to engage volunteers to strengthen public health, emergency response and stimulate community resiliency .

The Medical Reserve Corps keeps our communities a safe place to live, by supporting existing Fire, Emergency and Health professions . We assist neighbors in times of need, and during public health emergencies . Members build their resumes with free trainings and CEUs while having fun and helping neighbors to stay safe and well .

You do not need a medical background to volunteer, however wewelcomeanyonewithnursingexperience!If you would like to become a part of our amazing Medical Reserve Corps in both Sullivan and Merrimack Counties, give our Unit Director Jessica Rosman a call at 603-398-2222 or email: mrc@sullivancountynh .gov .

REGISTER NOW! We are also on Twitter: @GSCMRC, andonFacebook!@GSCPHN. Find us on the web: www.sullivancountynh.gov/mrc.

Page 18 • New Hampshire Nursing News April, May, June 2014

Paula Agrodnia Greenland, NH

Megan Alexander Exeter, NH

Lirio Ampongan Manchester, NH

Sandra Auvil Richmond, NH

Thomas Bathrick Claremont, NH

Henry Beaudry Nashua, NH

Brianna Beecher Nottingham, NH

Laurie Bennett New Boston, NH

Kathryn Bolduc Hampstead, NH

Joan Boutwell Merrimack, NH

Brenda Burke Salem, NH

Karen Carpenter East Hampstead, NH

Kelly Collins Manchester, NH

Tracey Cookson Merrimack, NH

Amanda Cormier Jefferson, NH

Katelyn Crosby Dunbarton, NH

Carol Dahl-Devries Thetford CTR, VT

Stephen Davis Lebanon, NH

Dawn Decosta-Gallo Greenfield, NH

Grace Desrosiers Rochester, NH

Jennifer Dickie Windham, NH

Ludovic Duffroy Manchester, NH

Amy Eilertsen Hanover, NH

Michelle Flattes Derry, NH

Christopher Frazee Portsmouth, NH

Jaclyn Gagne Merrimack, NH

Rose Gagnon Manchester, NH

Robyn Galvin Nashua, NH

Erin Gatsas Londonderry, NH

Ariel Gaudet Wakefield, MA

Marjorie Godfrey Lebanon, NH

Sharon Greenhalgh Litchfield, NH

Devere Groleau Laconia, NH

Jonathan Harvey Methuen, MA

Sharon Herdlein Manchester, NH

Tasha Humphreys Barrington, NH

Elaina Johnson Colebrook, NH

Wendy Jones Greenland, NH

Rebecca Kelly Merrimack, NH

Pamela King Belmont, NH

Cindy Kolenda Manchester, NH

Melissa Kubicki Bedford, NH

Amanda Kuzmick Newmarket, NH

Donald Lafave Warner, NH

Samantha Laferriere Quechee, VT

Ann Lak Dover, NH

Clifford Laplante Keene, NH

Kathryn Lawrence Bedford, NH

Priscilla Leblanc Rochester, NH

Ellen Lock Barrington, NH

Frances Lufkin Benton, NH

Melinda Luther Hollis, NH

Lisa Marshall Chester, NH

JoElla McCarragher Meriden, NH

Jane McGrath Nashua, NH

Vanessa Mendez Zapata Nashua, NH

Annalisa Miller Lee, NH

Jennifer Mills Litchfield, NH

Brittany Moccio Rindge, NH

Heather Moreau Bow, NH

Ann Moser Mason, NH

Mary Nagel Gilmanton, NH

Joyce Neilsen Wilmot, NH

Jillian Nemcovich Franklin, NH

Oluwadamilola Ogunbayo Manchester, NH

Sharon Oiekmlus Bedford, NH

Tina Pageau Gorham, NH

Ellen Parker Randolph Center, VT

Cassandra Pavone Hudson, NH

Jaime Payson Wilder, VT

Jennifer Pedley Windham, NH

Sherri Perry Ashland, NH

Courtney Peterson Grantham, NH

Nikki Pimental Pembroke, NH

Deborah Rice Nashua, NH

Samantha Richardson Gaithersburg, MD

Suzanne Riley Plymouth, NH

Sue Rogers Dover, NH

Jamie Rounsaville Grantham, NH

Michelle Rudis Rehoboth, MA

Michelle Rudis Rehoboth, MA

Joanne Samuels Durham, NH

Laine Schofield Littleton, NH

Stacy Shalno Exeter, NH

Stacy Shalno Exeter, NH

Georgette Shapiro Greenwood, NH

Cheryl Shirley Concord, NH

Phyllis Shoemaker Laconia, NH

Joanne Shomphe Farmington, NH

Lynda Skowronski Charlestown, NH

Maria Smith Nashua, NH

Carla Smith Fremont, NH

Judith Spencer Campton, NH

Sheryl Stevens Pembroke, NH

Sandra Tanis Exeter, NH

Sue Theriault Fairbanks, AK

Brenda Windgate Nashua, NH

Margaret Wink Brookline, NH

Nicole Young Milford, NH

WeLCome neW & reinstAted members

April, May, June 2014 New Hampshire Nursing News • Page 19

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The region’s leader in nursing education

420 S. Main Street, Nashua, N.H. • www.rivier.edu/nursing • 1-800-447-4843 • gadmissions@rivier.edu

Undergraduate and Graduate Programs to Advance Your Career

Complete your bachelor’s degree with our Online RN-BSN program. Advance your career with one of our four master’s degree programs including our new online M.S. in Nursing Leadership Reasons to advance your nursing career at Rivier University:• Strong educational partnerships with many of the region’s top hospitals in New Hampshire and Massachusetts

• Clinical and practicum courses capped at eight students per section

• Online nursing classes and nearly all classroom sections capped at 22

• All programs are accredited by the Accreditation Commission for Education in Nursing (ACEN-formerly NLNAC)

• Programs are designed to accommodate your busy nursing schedule

10 Paid Holidays. Health, Dental &

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efits

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Sullivan County Health Care

“All day, every day, we make life better.”

Positions availableRNs & LPNs

Full Time 3-11 or Per Diem

IV certification and experience is preferred for nurses, but we will train. This is an opportunity you do not want to pass up.

For more information, or to set up an interview, please contact Human Resources (603) 542-9511 ext. 286 or

humanresources@sullivancountynh.gov5 Nursing Home Drive

Unity, NH 03743

Cedarcrest Center for Children with Disabilities Keene, New Hampshire

… enriching the lives of children with complex medical and developmental needs and supporting their families through exceptional medical care, special education and therapy

services in a warm, home-like setting for 65 years …

Director of Nursing Services As Cedarcrest Center’s clinical leader, our Director of Nursing Services is responsible for maintaining exemplary standards of care and a culture of caring and commitment throughout the organization.

Requirements include:

■ RN, BSN Licensure (or eligibility) in New Hampshire ■ Minimum 3 years in pediatrics and 3 years in a leadership role ■ Experience with children with multiple disabilities and/or chronic health

needs preferred

Send cover letter, résumé, and three letters of reference to: Christine Hadley, HR Coordinator,

Cedarcrest Center, 91 Maple Avenue, Keene, NH 03431

EOE

For more information and a complete position description, see our website:

www.cedarcrest4kids.org

Page 20 • New Hampshire Nursing News April, May, June 2014

A 48-year-old woman with sleep apnea had surgery at a hospital for a detached retina. The surgery went well, and the patient was admitted overnight for observation.

That evening, the nurse gave the patient Demerol for pain as prescribed. When the patient vomited shortly thereafter, the nurse assumed the medication had been expelled and gave the patient another dose. Later, the patient complained of inadequate pain control. The nurse alerted the physician, who ordered another pain medication. By 1:15 a.m., the patient coded. The team could not resuscitate her.

The patient’s daughter filed a lawsuit. The case was settled for more than $1 million, split evenly among the nurse and two physicians.1

COULD YOU MAKE THIS MISTAKE— AND BE SUED?

OFFERED BY THE AMERICAN NURSES ASSOCIATION

We all make mistakes. But as a nurse, one mistake can lead to disaster. Consider this real-life example.

1 Source: Forum, May 20082 Please contact the program administrator for more information, or visit proliability.com for a free quote.

It’s because of cases like this that the American Nurses Association (ANA) offers the Nurses Professional Liability Program. It protects nurses from the potentially devastating impact of malpractice lawsuits.

Get the protection you need—without paying more than you need. To take advantage of special rates for ANA members, visit proliability.com for an instant quote and to fill out an application.

65671 (4/14) Copyright 2014 Mercer LLC. All rights reserved.

Underwritten by Liberty Insurance Underwriters Inc., a member company of Liberty Mutual Insurance. 55 Water Street • New York, New York 10041

Administered by: Mercer Consumer, a service of Mercer Health & Benefits Administration LLCIn CA d/b/a Mercer Health & Benefits Insurance Services LLCAR Ins. Lic. #303439 | CA Ins. Lic. #0G39709

MALPRACTICE INSURANCE OFFERED BY THE ANA ANNUAL PREMIUM AS LOW AS $982

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Their StoriesAre Our Stories.

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Due to our continued growth, we are always on the lookout for exceptional individuals to join our nursing team. If you are just starting out, or are a current nurse interested in a career in rehab, we have opportunities for you.

At the HealthSouth Rehabilitation Hospital of Concord, we achieve better outcomes by providing our employees with what they need to grow and advance in their profession. Learn more about the difference you can make in your profession as a member of our collaborative team.

Achieve better outcomes for your patients and career by joining the HealthSouth Rehabilitation Hospital of Concord, where we combine superior resources and support to impact your career growth, and the lives of those we serve. We are a 50-bed facility specializing in comprehensive inpatient and outpatient rehabilitation.

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