Inside Utah Nurses Association Centennial Celebration ... · Centennial Celebration: 1914-2014 Friday, October 10, 2014 Salt Lake City, UT The Utah Nurses Association will celebrate

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Nurses Day at the LegislaturePage 5

New Scholarship at Westminster Helps Nurse Practitioners Fulfill

Their PassionPage 11

Inside

The official newsletter of the Utah Nurses Association May,June,July2014 Volume23•Number2

www.utahnursesassociation.com

Quarterly circulation approximately 30,000 to all RNs, LPNs, and Student Nurses in Utah.

The Utah Nurses Association is seeking nominees in the following categories:

Outstanding Wasatch Front Clinician Outstanding Non-Wasatch Front Clinician

Established Nurse LeaderEmerging Nurse Leader

Outstanding Nurse Researcher (Clinical) Outstanding Nurse Researcher (Educational)

Nurse HistorianNurse Educator (Clinical)

Nurse Educator (Academic)Local Nurse Volunteer (mainly serving Utah)

International Nurse VolunteerNursing Organization with Greatest Community Service

Award recipients will be recognized at theCENTENNIAL CELEBRATION AWARDS CEREMONY

OCTOBER 9th, 2014Nomination submissions must consist of a narrative describing examples of the nominee’s excellence, two

professional letters of recommendation, and the nominee’s resume or curriculum vitae. The nominee must provide permission to be nominated prior to submitting the nomination. UNA membership is NOT required to be nominated.

Nominations must be submitted [email protected]

Deadline extended to May 28th, 2014

CALL FOR

NOMINATIONS

Utah Nurses Association Centennial Celebration: 1914-2014

Friday, October 10, 2014Salt Lake City, UT

The Utah Nurses Association will celebrate 100 years in 2014 and invites you to submit an abstract for a poster to be displayed at the 2014 Centennial Celebration.

**Deadline for Abstracts – on or before June 1, 2014**

This celebration will focus on the history of nursing in Utah, current health policy, nursing education, and cutting-edge clinical care. Posters may include clinical research as well as creative works or works of scholarly inquiry. Abstract submissions should describe original programs, projects or documents created, developed, or implemented with at least one objective related to the conference focus. Posters should be balanced, based on best evidence available, and free from promotional bias.

Posters may include quantitative or qualitative research as well as creative works or works of scholarly inquiry such as literature reviews or analysis of pertinent topics. Creative

CALL FOR POSTER ABSTRACTS

CALL FOR PODIUM PRESENTATION

ABSTRACTSThe Utah Nurses Association will celebrate 100

years in 2014 and invites you to submit an abstract to be considered for a podium presentation at the 2014 Centennial Celebration. The celebration will focus on the history of nursing in Utah, current health policy, nursing education, and cutting-edge clinical care.

**Deadline for Abstracts – on or before June 1, 2014

The 55 minute presentation should celebrate an historical or 21st century aspect of nursing. The topic(s) should fall into one of the following categories: policy/ legislation, education, or clinical practice. Presentations should be balanced, based on best evidence, and free from promotional bias. Research may include quantitative or qualitative research as well as works of scholarly inquiry

Podium Presentation Abstracts continued on page 4 Poster Abstracts continued on page 4

Page 2 • Utah Nurse May, June, July 2014

Published by:Arthur L. Davis

Publishing Agency, Inc.

utahnursesassociation.com

2014 BOARD OF DIRECTORSPresident Kathleen Kaufman, MSN, RNPresident Elect Catherine Coverston, RN, PhD First Vice President Jody Wolfe, RN, BSN, MBASecond Vice President Peggy H. Anderson, DNP, MS, RNSecretary Alana Jacobs, PhD, APRNTreasurer Karen de la Cruz, RN, MSN, AACNP/FNP

STAFF MEMBERSOffice Manager Lisa TrimContinuing Education Sandra Haak, PhD, RNLobbyist Justin StewartEditor Jody Wolfe, RN, BSN, MBA

COMMITTEE/COUNCILCHAIRS & LIAISONSBy-Laws Donna Eliason, RN, MS, CNOR Continuing Education Sandra Haak, PhD, RNFinance Karen de la Cruz, RN, MSN, AACNP/FNPGovernment Relations Kathleen Kaufman, RN, MSMembership Nominating Sharon K. Dingman, DNP, MS, BSN, RN

UTAH NURSES FOUNDATIONPresident Marianne Craven, PhD(c), RN

PRODUCTIONPublisher Arthur L. Davis Publishing Agency, Inc.

Editor and Publisher are not responsible nor liable for editorial or news content.

Utah Nurse is published four times a year, February, May, August, November, for the Utah Nurses Association, a constituent member of the American Nurses Association. Utah Nurse provides a forum for members to express their opinions. Views expressed are the responsibility of the authors and are not necessarily those of the members of the UNA.

Articles and letters for publication are welcomed by the editorial committee. UNA Editorial Committee reserves the right to accept of reject articles, advertisements, editorials, and letters for the Utah Nurse. The editorial committee reserves the right to edit articles, editorials, and letters.

Address editorial comments and inquiries to the following address: Utah Nurses Association, Attn: Editorial Committee 4505 S. Wasatch Blvd., Suite 330B Salt Lake City, UT 84124 [email protected], 801-272-4510

No parts of this publication may be reproduced without permission.

Subscription to Utah Nurse is included with membership to the Utah Nurses Association. Complementary copies are sent to all registered nurses in Utah. Subscriptions available to non-nurse or nurses outside Utah for $25. Circulation 27,000.

All address changes should be directed to DOPL at (801) 530-6628.

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, [email protected]. UNA 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 Utah 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. UNA 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 UNA or those of the national or local associations.

PUBLICATIONThe Utah Nurse Publication Schedule for 2013-2014

Issue Material Due to UNA OfficeAug/Sept/Oct 2014 June 9, 2014

Guidelines for Article DevelopmentThe UNA welcomes articles for publication. There is no payment for articles published in the Utah Nurse.1. Articles should be microsoft word using a 12 point font.2. Article length should not exceed five (5) pages 8 x 113. All reference should be cited at the end of the article.4. Articles (if possible) should be submitted electronically.

Submissions should be sent to:[email protected]

orAttn: Editorial CommitteeUtah Nurses Association

4505 S. Wasatch Blvd., Suite 330BSalt Lake City, UT 84124

Phone: 801-272-4510Fax: 801-272-4322

President’s Message

Kathleen Kaufman

This newsletter is a service of the Utah Nurses Association and your

receipt of it does not mean that you are automatically a member. Your

membership in support of this work is encouraged; please visit


Kathleen Kaufman, MSN, RNPresident

The first quarter of 2014 has been a very busy quarter due to the general session of the Utah State Legislature and also due to some in-house strategic planning.

In January the full board of directors met. This included our four new Director’s at Large: Sharon Dingman, Lori Gaucher, Angela Goetz and Aimee McLean. We discussed many aspects and priorities of our organization and decided that, in collaboration with the Western Multi-States Division, we would enhance our advocacy mission through working on retention of members and better communication with members and with the public. This year is also our 100th anniversary year and we acknowledged that this year we also want to focus on celebrating what is right with nursing in Utah. Part of this celebration is to recognize outstanding nurses throughout the state. Please seriously nominate a nurse you know for one of our many awards. The call for nominations is in this issue of the Utah Nurse.

All organizations who seek to be effective need to attract and retain active, interested members. The Utah Nurses Association is no different. We actually do attract a good number of new members each year, but often these members do not renew their membership. We would like to know what attracts you to the organization and what would make it worthwhile for you to maintain your membership. To this end we are preparing a survey of our membership and we hope that as many members as possible will respond to the survey. Most likely this will be done with Survey Monkey and will be anonymous. An interested, dedicated membership will make the UNA stronger and more effective in the health care arena. Be candid and constructive in the survey you will see in your email box soon.

We are also reaching out to other professional nursing organizations to form affiliations that will enable us to present a unified nursing voice in Utah. This is certainly appropriate given our mission to educate and advocate for all our nurse colleagues and the citizens of Utah. We need to work together with other groups to improve health care quality and accessibility throughout the state. We will continue our rural visits that we initiated last year in order to listen to the voices of nurses throughout the state.

One role of the Utah Nurses Association is to monitor, evaluate, and assess pertinent bills in the legislature. This year most health-related bills were introduced in the second third of the session or later. This required an immediate analysis of the bills and your Government Relations Committee rose to the occasion admirably. Some creative legislation addressing appropriate responses to overdose situations by the public was introduced by Representative Carol Spackman Moss. Senator Todd

Weiler’s bill will require all health care providers to clearly indicate their name and license on legible badges or on clothing for the benefit of their patients. Two pieces of legislation addressed removal of barriers to practice for nurse practitioners. One passed, one did not. And, of course, the most prominent health care issue of this session has been the question of Medicaid expansion. Please see the articles in this Utah Nurse issue on these and other bills.

The Government Relations Committee reviewed many bills and took positions on several bills as indicated in the bill tracker on our website. Some legislation whipped through the HHS committees so quickly that an immediate position was required. This was especially true in the first version of SB48 which sought to redirect telephone fees from support of the Utah Poison Control Center to the general development of the EMS system in Utah. While supporters of the Poison Control Center had little time to prepare testimony, they did rally excellent support and strong presentations that resulted in a rewrite of the bill that ultimately made some cuts but not the original massive cuts that would have devastated the center. This is a living example of effective citizen interaction with the legislators. I was honored to be asked to be present to indicate nursing’s support of the center.

Now that the legislative session is over, we can catch a breath before the interim meetings begin. As your president, I plan to attend as many Health and Human Services Committee interim meetings as possible in order to stay informed of upcoming trends in legislation. There will be continued study of the Utah approach to health care reform and I will keep you appropriately informed on this. I encourage anyone who is interested in attending interim sessions with me to contact me through the UNA office. These meetings can be very interesting and I welcome your company.

As we finish out the first quarter of the year and move into spring in late March, the UNA will be hosting the Western Multi-State Division (WMSD) for a regional meeting. We will review progress towards the WMSD’s goals of improved retention, a regional continuing education process, and improved communication within states and within the WMSD. The leader of the WMSD, Robin Schaefer, will be spending another day or two working with UNA board members on association operations and priorities. Ms. Schaefer is the experienced executive director of the Arizona Nurses Association as well as the lead in the WSMD. We are working for a better, more effective and stronger association in Utah to serve the nurses and the citizens of Utah. Join us!

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May, June, July 2014 Utah Nurse • Page 3

INTERNET NURSINGUTAH NURSES ASSOCIATION receives its Internet

services due to a generous grant from XMission, Utah’s largest and best local Internet Service Provider. For more information on XMission’s services and pricing visit XMission on the Web at www.xmission.com or call 801-539-0852.

Please visit the Utah Nurses Association’s Web Page!

utahnursesassociation.com

Visit our site regularly for the most current updates and information on UNA activities. You can obtain a listing of Continuing Education Modules available through UNA or a listing of seminars and conferences that offer CE credits.

ContentThe Official Publication of the Utah Nursing Association

2 President’s Message

4 Letter to the Editor

5 Nurses Day at the Legislature

7 When Will Healthcare and Nursing Move from the Control of

Organized Medicine?

12 Walking in Our Sleep: The Short and Long-Term Impact of Insufficient

Sleep

15 Membership Application

Attention UNA MembersYou can now find us on Facebook. Just search Utah Nurses Association and look for the page with the UNA logo. We will be posting updates for upcoming events and information on conventions in our blog.

• Director of Nursing Program and Assistant Department Head - Provide exemplary vision and leadership for statewide nursing programs and the development of new BSN programs.

• Program Coordinator at USU-Blanding Campus

For more information about these positions please visit jobs.usu.edu.

POSITIONS AVAILABLE WITH UTAH STATE UNIVERSITYNURSING LEADERSHIP

UTAH STATE UNIVERSITY IS SEEKING APPLICANTS FOR THE FOLLOWING POSITIONS:


such as literature reviews or analysis of pertinent topics. Presenters are required to register for the conference at a discounted rate.

All submissions will undergo peer-review. Please carefully review the instructions as incomplete submissions will not be reviewed for consideration. Membership in the Utah Nurses Association is preferred but not required.

Instructions for Podium Presentation Abstract Submission

• All submissions should be emailed to [email protected] no later than midnight on June 1, 2014.

• Include in the body of the email: name(s) of person(s)submitting abstract, phone number, and email contact information. The subject line should read: Call for Presentation Abstracts.

• A completed UNA biographical data and conflict ofinterest form must be attached to the email.

• Theabstractsubmissionshouldbeanattachment to theemail, not in the body of the email.

• Theabstract shouldbe limited to500words, excludingthe title and author(s).

• Theabstractwillconsistofatitlepagewith:

• PresentationTitle

• Author(s)FullNameandCredentials

• PositionTitle

• NameofInstitution/OrganizationAffiliation And a body (500 words) with the following section headings

• LearningNeedsAssessment

• Description of identified gap(s) in learnerknowledge, skill, practice

• Descriptionofcurrentstate

• Descriptionofdesired/achievablestate

• Purpose: (write as an outcome statement, e.g. “Thepurpose of this learning activity is to enable the learner to…..”

• LearningObjectives,i.e.behaviorsthelearnerwillbeable to perform at the end of the activity

• ContentOutline for each objective. Itmust bemorethan a restatement of the objective.

• Timeframeforeachobjective.Thetotalpresentationmust not be longer than 55 minutes.

• Description of teaching methods, strategies, andresources (lecture, discussion, case study, question/answer) for each objective

• Learningevaluationmethodsandstrategies(question/answer, quiz, case study)

• Currentsupportingreferencesforthepresentation

• Abstractsubmissionswillreceiveareceiptconfirmationvia email.

• Notification: Authors will be notified regarding acceptance of their submission by July 1, 2014.

Podium Presentation Abstracts continued from page 1Poster Abstracts continued from page 1

works may include a wide variety of entries ranging from new teaching projects to poetry to visual or fiber arts.

Posters dimensions and display details will be conveyed upon acceptance. Presenters are required to register for the conference, pay appropriate registration, and be present to discuss their posters with attendees. One 25% discounted registration will be awarded to each accepted poster.

All submissions will undergo peer-review. Please carefully review the instructions as incomplete submissions will not be considered. Membership in the Utah Nurses Association is preferred but not required.

Instructions for Poster Abstract Submission:• [email protected]

by midnight June 1, 2014.

• Include in the body of the email: name of personsubmitting abstract, phone number, and email contact information. The subject line should read: Call for Posters.

• A completed UNA biographical data and conflict ofinterest form for each poster author must be attached to the email.

• Theabstract submissionsshouldbeanattachment to theemail, not in the body of the email.

• Theabstractshouldbelimitedto300words,excludingthetitle and author(s).

• Twocopiesoftheabstractwillbesubmitted.

• One copy of the abstract will consist of the followingsection headings:

• Postertitle

• Author(s)fullnameandcredentials

• Positiontitle

• Nameofinstitution/organizationaffiliation

• Learningobjectives/expectedoutcomes

• Description of program, project, or presentation -background, purpose, methods, results/outcomes, and implications for practice

• The second copy of the abstract will not include theauthor’s name, position, or institution affiliation.

• Abstract submissionswill receive a receipt confirmationvia email.

• Notification: Authors will be notified regardingacceptance of their submission by July 1, 2014.

I want to share my experience of participation on the ANA Code of Ethics Revision advisory committee with my fellow nursing colleagues. Participation in this committee has been rewarding, frustrating, and educational, offering me insight into the benefits of membership and participation in my professional organization.

The ANA has various professional issues panels concerned with nursing practice and health policy. These panels offer the nurse an opportunity to engage in dialogue with other nurses to shape policy and practice. The panels have both a Steering Committee and an Advisory Committee and are made up of ANA members from various practice areas. I applied for the Revision of the Code of Ethics for Nurses with Interpretive Statements Panel. My interest stems from my study on the content of social justice within the Code of Ethics and, through my participation, I hope to influence the code revision in terms of its social justice content. The Code of Ethics is the foundational document for nursing and as such, should more fully address the concept of social justice. The current revision of the ANA code is an opportunity to do this.

Application for participation on this panel was straightforward. Applicants must be ANA members and submit a statement of interest and a curriculum vitae. Everyone who applies by the deadline is accepted into either the steering committee or the advisory committee. The steering committee is made up of 15 members who meet one to two times a month via conference call and it is the steering committee who poses questions and topics for discussion to the advisory committee. There is an online forum, Nursespace, where discussion regarding questions posed by the steering committee take place.

As part of the advisory committee I participated in the Nursespace dialogue, by reading submissions and offering my own. This aspect of the process was frustrating at times as the conversation drifted in unrelated directions. In the beginning, and for quite a long time, the only question offered for discussion from the steering committee was regarding what would be optimal terminology (transprofessional vs interprofessional vs. intraprofessional) for use in the code. Discussion on this one question went on for quite a while, and although terminology is important, I began to wonder when input on more substantive issues would be solicited. The steering committee seemed to agree because the format for subsequent questions changed from blog-style to a more formal and detailed questionnaire that each participant completes. A summary of the responses is then sent out – giving us feedback on our input. I expect this will be the format until the close of the review in November, likely because it is a more manageable way to receive input from so many members. One advantage of this approach is that it avoids off-topic discussions and arguments and it may save time. A disadvantage is that it’s not possible to directly view (and thus understand) the comments of other nurse colleagues.

The Code of Ethics revision process is ongoing and committee input will be received until November 2014, at which time the ANA Board of Directors will begin consideration. I continue to enjoy my participation in this code revision. Because of this experience I have realized what a privilege it is to have a national organization that I can actively participate in. Through this participation, it has been evident that although not all of us are in agreement on different issues, we can still dialogue and learn from each other. I urge my fellow nurses to consider participation in a professional issues panel. It provides a concrete way to experience the benefit of membership in our professional organization by having a voice in its mission and growth.

Respectfully,Anne Daly, RN, [email protected]

Letter to the Editor

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Join Utah Nurses Association Today!

Application on page 15 orjoin online at



Nurses Day at the Legislature

Kathleen Kaufman MSN, RN and Donna Murphy, RN, MSN, CPN

On March 7th, the Utah Nurses Association sponsored Nurses Day at the Legislature. We welcomed a good number of attendees who came to learn about the legislative process and current health-related bills pending in the Legislature. Student nurses from Brigham Young University and Salt Lake Community College were among the audience as well as an encouraging number of professional nurses who took the day off to be present. Donna Murphy facilitated the whole Nurses Day and set up a computer station at which attendees could identify their own legislators. She also explained how to use the blue and green note sheets to ask legislators to come off of the floor to speak to their constituents. After the formal part of the day was over, Donna took those who were able to stay, into the Senate and House galleries where they were recognized by the legislative bodies.

Rylee Curtis, Medicaid analyst for Utah Health Policy Project led off the discussion with a clear and concise explanation of the Medicaid Expansion issue. This was very valuable background since most of the legislators who came to share their thoughts were focused on the Medicaid expansion. Senator Brian Shiozawa, Representatives Marie Poulson, and Rebecca Chavez-Houck all discussed the need for Medicaid expansion while Senator Allen Christensen decried the need for more federal dollars, and declared that “charity care in Utahis very strong and can provide the care needed by the uninsured.”

A few other ideas arose such as the need for appropriations to implement a provider-government partnership pilot for dental care in community health centers. Using this issue as an example, Representative Tim Cosgrove explained how a good idea can be passed into law, but not funded through the appropriations committee. Our UNA lobbyist, Justin Stewart, explained the many ways that a bill does or does not pass into law. To do this in part, he described the demise of HB 139, Nurse Practitioner Amendments, which died in the House Health and Human Services Committee.

We were also treated to the advice of a citizen political activist who was lobbying about his passion for good public policy. Encouragement for nurses to become involved in the political process came from former Senator Ross Romero who will be running again for the Senate District 4 in the next election. The audience was attentive and asked informed questions of the legislators. Several nurses and student nurses ran a blood pressure station. Patient education materials for cardiac health and blood pressure control were distributed. We thank those who took the time to provide this service.

Next year’s Nurses Day at the Legislature will be held Friday, February 27 , 2015 in the Rotunda. We hope to see you there, and if you have any suggestions for the occasion, PLEASE write us….call us….or email us….. We love hearing from you as professionals who are valued and trusted. Your voice is of extreme significance due to all the changes in health care policy. Never underestimate your power as a constituent as well as a nurse! Get to know your elected officials before the legislative session begins so they can learn how you feel about specific issues which make a difference in all of our lives.

Rep. Rebecca Chavez-Houck, Kathleen Kaufman, and

Donna Murphy

Sen. Shiozawa, Donna Murphy, and Rep. Marie Poulson

The Utah Action Coalition for Health: Making a Difference for

Utah Nurse PractitionersSubmitted by Joan M. Gallegos, RN, CSW, February 21, 2014

The Utah Action Coalition for Health (UACH) brings together a diverse group of the state’s strongest leaders to implement the Institute of Medicine (IOM) report recommendations that provide a blueprint for transforming the nursing profession to improve health care and meet the needs of diverse populations. The UACH is one of thirty six state-based Action Coalitions formed to promote nursing leadership, remove barriers to practice and care, and to advance education transformation. The UACH co-leads are Maureen Keefe, Dean Emeritus, RN, PhD, FAAN and Juliana Preston, Executive Director, HealthInsight.

Many exciting activities have happened in the past months which have removed barriers to Medicaid coverage and reimbursement for nurse practitioners. This has been a priority focus of work for the UACH. The following are some of the significant Medicaid policy changes:

1. All Nurse Practitioners (NPs) will now be eligible to become Medicaid providers. Historically, only pediatric and family NPs have been allowed to be Medicaid providers, as these groups were required to participate by federal regulation. Now, due to a persuasive policy argument made by the UACH, all licensed NPs are eligible to become Medicaid providers. This significantly broadens the provider pool to include such NPs as psychiatric/mental health, geriatric, women’s health, etc.

2. All NPs will be reimbursed at 100% of the physician fee schedule. Instead of being reimbursed at 75% of the physician fee schedule as was originally proposed by Medicaid, all NPs will be reimbursed at the 100% level. The “same pay for sameservices” argument was successfully made by the UACH on behalf of the NPs.

Medicaid is presently making changes to their State Plan and we expect these new policies to be in effect by April 1, 2014. Be expecting to hear from the Utah Medicaid Program soon regarding these new policies.

The UACH welcomes the involvement of all interested nurses who want to make a difference in Utah’s nursing profession. Please contact staff coordinator Joan Gallegos, [email protected] to learn more about the UACH and how you can make a difference in Utah’s nursing profession.

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Utah Nurses Association Legislative Review

Bill Number: HB 11Short Title: Overdose Reporting AmendmentsSponsor: Representative MossPosition: SupportStatus: Passed

This bill provides that a person who reports a person’s overdose from a controlled substance or other substance may claim an affirmative defense to specified charges of violating the Utah Controlled Substances Act. This only applies if the person remains with the person who is subject to the overdose and cooperates with responding medical providers and law enforcement officers. The bill also provides that remaining with a person subject to an overdose and cooperating with medical providers and law enforcement is a mitigating factor when determining the penalty for a related violation of the Utah Controlled Substances Act. This bill passed out of both bodies unanimously and should be signed by the Governor shortly.

Bill Number: HB 21Short Title: System of Care for Minors in State CustodySponsor: Representative SanpeiPosition: SupportStatus: Passed

This bill requires the executive director of the Department of Human Services to establish a system of care for minors with or at risk for complex emotional and behavioral needs. The bill requires the local substance abuse and mental health authorities to cooperate with the Department of Human Services in promoting the system of care model. This bill passed out of both bodies unanimously and should be signed by the Governor shortly.

Bill Number: HB 30Short Title: Controlled Substances AmendmentsSponsor: Representative RayPosition: SupportStatus: Passed

Thisbilladdsnew“spice”andemergingdruganalogsto the listed controlled substances. This is a section of code that will have to be updated every year. This bill passed both bodies and should be signed by the Governor shortly.

Bill Number: HB 35Short Title: Reauthorization of Utah Health Data AuthoritySponsor: Representative DunniganPosition: AmendStatus: Passed

This bill amends the membership of the Health Data Committee; the data sharing authority of the Health Data Committee. The bill reauthorizes the Utah Health Data Authority Act until July 1, 2024. This bill passed out of both bodies unanimously and should be signed by the Governor shortly.

Bill Number: HB 106Short Title: Employer Sponsored Clinic – Prescription Drug AmendmentsSponsor: Representative BarlowPosition: SupportStatus: Held in Committee

This bill exempts a prescribing practitioner from the licensing requirements of the Pharmacy Practice Act if the prescribing practitioner dispenses a prepackaged drug at an employer-sponsored clinic and complies with other requirements. This bill was held in committee because the sponsor was able to add the intent of this legislation into SB 55, which passed. With the sponsors language amended into another bill HB 106 was no longer needed.

Bill Number: HB 119Short Title: Opiate Overdose Emergency TreatmentSponsor: Representative MossPosition: SupportStatus: Passed

This bill permits the dispensing and administration of an opiate antagonist to a person who is reasonably believed to be experiencing an opiate-related drug overdose event. The bill establishes immunity for the good faith administration of an opiate antagonist. The bill requires a person who prescribes or dispenses an opiate antagonist to advise a person to seek a medical evaluation after experiencing a drug overdose and taking an opiate antagonist. This bill passed out of both bodies unanimously and should be signed by the Governor shortly.

Bill Number: HB 139Short Title: Nurse Practitioner AmendmentsSponsor: Representative RayPosition: SupportStatus: Failed

This bill allows an advanced practice registered nurse to prescribe a schedule II or III controlled substance without mandatory physician consultation by a consulting physician. This bill was heard in House Health and Human Services. The motion to pass it out of committee failed with a vote of 3-5. There are three doctors that are on the Health and Human Services Committee. Representative Kennedy voted for the bill while Representative Barlow and Representative Redd voted against the bill. This is a bill we will likely see in the future.

Bill Number: HB 143Short Title: Psychiatric Nurse AmendmentsSponsor: Representative ReddPosition: SupportStatus: Passed

This bill removes a provision that requires the applicant to complete the applicant’s clinical practice requirements before licensure for a advanced practice registered nurse; and adds a provision that requires the applicant to complete the applicant’s clinical practice requirements before renewal, or, if the applicant is renewing in less than two years, to demonstrate satisfactory progress toward completing the clinical practice requirements. This bill passed out of both bodies unanimously and should be signed by the Governor shortly.

Bill Number: HB 267Short Title: Aging and Adult Services AmendmentsSponsor: Representative Chavez-HouckPosition: SupportStatus: Passed

This bill clarifies and modifies the powers and duties of Adult Protective Services and makes the vulnerable adult database and the adult protection case file available to city attorneys. This bill passed out of both bodies unanimously and should be signed by the Governor shortly.

Bill Number: SB 55Short Title: Pharmaceutical Dispensing AmendmentsSponsor: Senator VickersPosition: Status: Passed

This bill modifies the definition of pharmaceutical wholesaler or distributor in the Pharmacy Practice Act to exclude a facility for which the facility’s total distribution-related sales of prescription drugs does not exceed 5% of the facility’s total prescription drug sales. The bill allows a hospital pharmacy that dispenses a prescription drug in a multidose container to a hospital patient and follows labeling requirements to provide the patient the drug when the patient is discharged. The bill establishes the license classification “dispensing medicalpractitioner” under the Pharmacy Practice Act for medical practitioners who prescribe and dispense a drug. The bill establishes the pharmacy facility license classification “dispensing medical practitioner clinic pharmacy” underthe Pharmacy Practice Act; creates Part 8, Dispensing Medical Practitioner and Dispensing Medical Practitioner Clinic Pharmacy. The bill removes the exemption from the Pharmacy Practice Act for medical practitioners who prescribe and dispense a cosmetic drug, injectable weight loss drug, or a cancer drug treatment regimen; requires a license as a dispensing medical practitioner for a health care practitioner to dispense: a cosmetic drug: a cancer drug treatment regimen; or a prepackaged drug at an employer sponsored clinic. This bill passed out of both bodies and should be signed by the Governor shortly

Bill Number: SB 57Short Title: Autism Services AmendmentsSponsor: Senator ShiozawaPosition: SupportStatus: Passed

This bill requires a health benefit plan offered or renewed in the individual market or large group market, on or after January 1, 2016, to provide coverage for the treatment of autism spectrum disorder for children 2 to 9 years of age. The bill describes minimum coverage limits for autism coverage and requires an assessment of treatment plan every six months. The bill permits the commissioner to waive coverage under this section if the attorney general issues a legal opinion that the limits on autism coverage are unenforceable under federal law. The bill provides a waiver for an insurer if premium costs increase by more than a certain percentage; and sunsets the autism coverage on January 1, 2019. This bill was a compromised bill between insurers and advocates and should be signed by the Governor shortly.

Bill Number: SB 137Short Title: Health Care Professional Truth in AdvertisingSponsor: Senator WeilerPosition: SupportStatus: Passed

This bill amends the unprofessional and unlawful conduct provisions of the Division of Occupational and Professional Licensing Act to require, beginning January 1, 2015, a health care provider, in a patient encounter, to wear a badge or clothing that identifies the health care provider’s name and license type. This bill passed both bodies and should be signed by the Governor shortly.

Bill Number: SB 168Short Title: Charity Care AmendmentsSponsor: Senator ChristensenPosition: Status: Passed

This bill requires a written waiver from a patient and provides immunity from liability to a health care provider who volunteers services at a federally qualified health center or an Indian health clinic. This bill passed out of both bodies unanimously and should be signed by the Governor shortly.

Bill Number: SB 251Short Title: Amendments to Medicaid and Health CareSponsor: Senator ShiozawaPosition: SupportStatus: Failed

This bill establishes a health care premium partnership program to provide an individual who does not currently qualify for Medicaid and who is below 100% of the federal poverty level with a premium subsidy to enroll in a health benefit plan. This legislation was trying to find a middle ground between the full expansion and no expansion. In the end it was decided that Legislative and Executive branch needed to keep working on a Utah solution to this issue.

UNA Lobbyist Justin Stewart


Penny Kaye Jensen & Jared Johnson

Unfortunately, HB 139 did not progress out of the Health and Human Services (HHS) Committee during the recent legislative session. This proposed change would have increased access to care and ensured continuity of the highest quality of care for Uthans. The passage of the Patient Protection and Affordable Care Act (PPACA) has prompted greater demands for health care services and providers. The proposed changes to the Utah Nurse Practice Act would have retired the consultation and referral plan for prescribing schedule II-III controlled substances. Removal of the plan would promote improved access to health care and enhance quality of care by:

• Increasing access to health care services for Utahns,especially in underserved and rural areas, by allowing timely access to APRNs who can provide the full array of services for which they are educated and trained.

• Decreasingdelaysinhealthcareservicesforpatientsinneed of necessary and critical medications.

• Reducing potential duplication of services anddecreasing costs for health care consumers.

By eliminating the consultation and referral plan, the above are accomplished without any expansion in prescribing practices. Instead, the bill would have allowed APRNs to continue to prescribe the medications they are currently prescribing without the hindrance of the consultation and referral plan. The plan was originally implemented to demonstrate that APRNs were safe prescribers of controlled substances. Utah licensure rules now require physicians and APRNs to meet the same continuing education requirements. The bill would not have changed or expanded the scope of practice or scope of care services that APRNs currently provide. The bill would have simply clarified accountability and responsibility in the prescribing process.

During the HHS Committee hearing, multiple committee members ultimately defeated full practice authority for APRNs by maneuvering the discussion away from improving access to health care for Utahns, as well as the fact that nursing as a discipline has the right to govern itself, with the ability to monitor drug abuse and opioid-related death related to poor prescribing practice. The Utah Medical Association (UMA) led a well-executed strategic attack against furthering NP practice. Sadly, the UMA managed to defeat HB 139 while failing to provide any published evidence to support the opposition opinion, although there is ample published evidence available regarding the safe prescribing practices of APRNs. A physician at the HHS Committee hearing alluded to an article, which was not published at the time of the hearing, which reported research demonstrating an increased risk of opioid-related death for patients of APRNs. The next

week when this article was made available it became quite clear that the conclusions in the article are not supported by the data from the study. In fact, the report was limited specifically to physicians-related outcomes only; there were no NP-related outcomes reported at all.

APRNs in Utah are appreciative of the approximately 50 who attended the hearing. However, given there are over 1,200 practicing APRNs in Utah, the attendance was low. For now Utah will remain the sole Western state, with the exception of California, that does not allow full practice authority for NPs. Political activity has long been a hallmark of professional nurses. Such social and political activity resulted in the inclusion of nurses in the care of military men in the Crimea under the visionary leadership of Florence Nightingale, and transformed care of the underserved later by Dorothea Dix and others. The modern era of nursing, however, has seen a vast deficit of nurse political interest and activity. As the nation’s most trusted profession and with nurses outnumbering every other health care profession, nurses are in a unique position to effect change and shape public policy and opinion. Physician colleagues, much fewer in number, typically have access to greater funds which has led nursing to accept them as the more powerful players in health care. Despite the foundational principle of nurse leadership upon which nursing has been modeled by Florence and later colleagues, we have become a profession of inactivists and victims. Health care has fallen under the leadership of the physician, as has insurance, policy, and many other aspects of our own professional work. As nurses, we have a duty and an obligation to ourselves, to our patients, and to the public to engage in political activism on all levels. While we may not have the individual financial might that many physicians wield, we have something far more politically powerful if we will use it – we have large numbers, with passion for patients that is palpable.

To shape the future of health care, each and every nurse needs to move passion to commitment to engage in the apparently convoluted process that is modern US politics. Nursing cannot remain a profession of sideline spectators who expect a small handful of nurses to do the work and be the voice of tens of thousands in Utah and of millions nationally. We often view with excitement, disappointment, and often horror, the game played on the public field of politics, in our hospitals, clinics, and in society. We feel that we are small and weak and can do nothing to improve our working conditions, patient care, or to change hospital, state, and national policies that deter nurses. The secret the opposition holds, and hopes nurses never fully understand is relatively simple: the power wielded by big pharma, medicine, and other financially powerful professions depends on the persistent subservience of nursing and nurses. The opposition depends on emotional responses, sustained feelings of helplessness and fear, and tactics to suppress the voices of nursing, which all aid in domination at our expense. If we

were to realize that all of health care depends on nursing, our passion for patient care brought to the forefront, and our voices in unison heard, the future of Utah and the United States would be forever altered.

What if we acknowledge that patients are admitted to hospitals not for the medical professionals who write orders, but for the professional nursing care we provide? What if we recognize that home health care is wholly dependent on nurses after brief and infrequent assessments by physician providers? What if we remember the mighty power of Clara Barton, Mary Breckenridge, Dorothea Dix and others who led our profession into new and exciting eras and territories? What if we stop being the unfortunate victims of a game in which we feel we cannot play? Imagine for a moment that all of the above questions caused a deep awakening in nurses across Utah. We believe we would see an increase in wage that is reflective of the expert knowledge and skill required of professional nurses at all levels. We believe we would see an increased respect for nursing and nurses. We believe our state legislators would realize, in short order, that nurses care about more than the patients on their shift or in their clinics. We are powerful because of our numbers, as well as our passion for the care of patients. One decade ago it was estimated that 1 in 44 women voters was a nurse and 1 in every 100 adults in a nurse. There is also an estimated 10,000 nurses per US congressional district. We must not fail to recognize our professional power when history has taught us there is strength in numbers. Today is the day to commit yourself to shaping the future for nursing and for your patients!

Porucznik, C. A., Johnson, E. M., Rolfs, R. T., & Sauer, B. C. (2014). Specialty of prescribers associated with prescription opioid fatalities in Utah, 2002-2010. Pain Medicine, 15(1), 73-78. doi: 10.1111/pme.12247

When Will Healthcare and Nursing Move from the Control of Organized Medicine?

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Dallen Ormond, NP, PhD

For a Nurse Practitioner (NP) barriers to practice are an obstacle to which we all deal with individually every day. Whether we passively accept our relegated and often subservient roles, or individually stand up for our practice standards, education, and patient’s rights we spend much of our time and energies dealing with these frustrations. The most difficult hurdle we often face is credibility. Lack of credibility that is created by being the invisible heath care provider. When I was a student I believed that the evidence regarding NP care and quality would ultimately win out in the final analysis, however after 15 years , 12 of which operating a practice, I have serious reservations over the future of our profession. I fear that recent events within our local insurance community will significantly limit the future of Nurse Practitioners.

Over the years NP’s have been very active politically, lobbying to improve state practice acts with recognizable success. For these efforts I applaud our colleagues and hope for continued improvements. The focus of this article is on non-legislative efforts that work silently against us, but nevertheless regulate and castigate the NP role. These efforts prevent professional advancement and the future of Nurse Practitioners.

Over a decade ago, legislative action was taken to allow NP’s to bill Medicare independently. In order to appease physician groups we had to accept a reimbursement rate at 85% of the physician fee schedule. While there were many upsides to this new ability, what was unknown at the time was that medical practices could not survive on this level of reimbursement. The outcome of the legislation was that for NP’s in large

Change in Nurse Practitioner Reimbursement Could this be the End of Independent Practice?

groups, specialties, and hospital settings, most Nurse Practitioners moved to billing “incident to.” For manyof us this has become a way of survival. If we cannot bill “incident to” we do not get reimbursed enoughfor a practice to be profitable. National statistics have demonstrated that in well run primary care offices overhead runs between 55% and 65% of revenues. This number does not include provider salaries. Traditionally the value of a Nurse Practitioner has been that we are paid 30-40% less than physicians in primary care, therefore if a NP collects $500,000 in revenue in a year and a Nurse Practitioner is paid $100,000 in salary and benefits the practice makes an additional $30,000 -$40,000, over that of a physician with similar revenues annually. If that same Nurse Practitioner’s revenues are decreased by 15% to $425,000, the practice overhead does not decrease, and the profitability of the NP drops to $25,000. When compared to the profitability of a physician collecting the same annual revenue the Nurse Practitioner becomes far less profitable than a physician, even though the NP is paid less.

To legally bill “incident to” a physician not only hasto sign off on your chart (thus despite lack of state law requiring co-signature your charts are co-signed by a physician), but the physician also physically has to perform the initial history, physical examination, and organize the plan of care. If there is any change in the patient’s condition that physician has to re-evaluate the patient. Practicing within these requirements completely negates any hard fought legislative victories. If, as an NP, you decide to bill independently your collection rate, at 85%, creates a reimbursement rate that makes profitability difficult. Because of a lack of profitability with independent billing many NP’s have resigned themselves to a professional life of “incident to.”Legallyby billing “incident to” an NP cannot build their ownpractice, or their own following of patients.” Incident to” billing is a serious threat to independent practice, and a form of professional discrimination. Recently the Federal Trade Commission has weighed in on the issue of patient access to Nurse Practioners. Incident to billing directly contradicts the recommendations of the FTC.

Thankfully, for most of us, Medicare reimbursement does not encompass the majority of our revenues, and if you are in primary care, with a broad range of patients of variousagesthe85%Medicareruleand“incident-to”havenot affected your practice or your patients’ ability to have access to you as a health care provider. Most insurances still credential and reimburse NP’s independently and reimburse at the same rate as the physician (including Medicaid) for the same service. Recently however, this has all changed in a very serious way, and lack of action on our part may result in loss of practice rights, privileges and jobs.

So what is the change? Eight years ago IHC/Select Health elected to independently credential Nurse Practitioners. When this occurred they stated that they would pay at 85% of the physician fee schedule. As an olive branch to large physician owned practices they allowed NP’s to bill underneath a physician in the same office without following “incident to” rules. This allchanged in September 2013. IHC/Select Health has been enforcing these rules and taking back payments that do not meet“incidentto”guidelines.Therefore,ifyouhavelargeprimary care practice and 20-25% of your patient volume is Select Health you can no longer perform a well check, you can no longer initiate treatment for hypertension, and you can no longer fix a broken arm without a physician seeing the patient first OR billing under your own name at an 85% reimbursement rate.

While Select Health and a few small federal Blue Cross plans are the only insurance plans to make this change the problem is that it may signal future trends. After meeting with authorities from Select Health, the following has been made very clear to me:1.) NP’s are not viewed as offering the same services as

physicians.2.) NP’s are not seen as independent primary care

providers, or as having the same ability to provide primary care as physicians.

Rather than sit and complain about our circumstances I believe we need to make the following changes as a Nurse Practitioner community:1.) If you work in primary care build a practice of your

own. Make it as large as possible, and let your patients know that the extraordinary care they are receiving is by a Nurse Practitioner.

2.) If you are not trained to provide the same primary care services that the physicians in your practice get the training and certification necessary to provide the same services. I could stand on a soap box all day with regard to this point. It seems every online university in America is now offering an NP degree. I work with these students as a preceptor often. I am continually astounded at what they are told is “out oftheir scope of practice” and what they are not trained to do or perform. We have to be able to perform a similar complement of primary care services as primary care physicians, and I would add perform them very well.

3.)DONOTbill“incidentto”ifyouworkinprimarycare.Bybilling“incidentto”theinsurancecompaniesdonotsee the work you perform; you become the invisible health care provider. If they don’t see the numbers they don’t change.

4.) We need allies. As much as this hurts us it will also hurt physicians. Recruit the physicians to lobby the insurance companies for change.

5.) We do not need any more enemies. Recent events made manifest with the attempt to pass HB 139 clearly demonstrate that we have plenty of enemies. Choose a path that demonstrates our capacity as health care providers earnestly engaged in creating a healthy friendly relationship with Select Health, and other insurance providers. Become part of committees at your local IHC hospitals, work cooperatively with their systems and demonstrate our benefits to their system.

In my opinion this issue is of greater importance than any current NP legislation. Stand up and take action or you may be working on a med-surg unit in your local hospital again very soon.

www.tchealth.org • [email protected]

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by Sharon K. Dingman, DNP, MS, BSN, RN

Patient-centered care is the focus of numerous efforts by health care organizations. Nurses are specifically poised to be the leaders of innovative frontline practice initiatives to achieve organizational performance excellence and sustainability. Many organizations are hardwiring practice initiatives, such as; bedside shift reports, post discharge phone calls, scripting, new models of care management, and other patient advocate strategies to ensure patients move safely across settings. Creating the “wow” factor of nurse-patient engagement is amotivator.TCM provides the perfect vehicle for dialogue about caring behaviors of nurses and the value of the tone and content of nurse- patient interactions to the patients perceptions of caring. Hardwiring of care delivery is as much about the way it is communicated to the caregiver and patient, as is about the actual activity or initiative itself.(1-2)

Hospitals and other health care facilities have the opportunity to improve the patients’ perceptions of care and communication with nurses by strengthening the quality of caring and compassionate interactions of nurses with patients and families. TCM’s four new modules identify nurses’ perceptions of caring and compares these perceptions with patients’ perceptions to the nurse interactions in their hospital stay as the patient. The Patient Experience of Care is measured in eight domains by Hospital Consumer Assessment of Healthcare Providers (HCAHPS). Communication with Nurses is correlated with multiple measures and as these scores raise, so does the other aspects of the associated domains.(3)

Patient satisfaction continues to be an essential indicator of quality care.(1-2) HCAHPS survey results are partially tied to and impact hospital Medicare payments as of October 2012. Customer service is now enhanced by the patient experience of care dimensions that are driven from the patient perceptions of the nurses caring and compassion. Communications with Nurses, in particular, is strongly associated (or in other words – significant) with hospital performance on HCAHPS and other Centers for Medicare and Medicaid Services (CMS) payment programs.(4)

Focusing on nursing communication efforts makes sense. Thirty-percent of hospitals Value Based Performance (VBP) incentive payments are determined by how patients evaluate their stay. Hospitals can impact half of this 30% by focusing on one metric –

Communications with Nurses (Press Ganey, 2013). Efforts to improve the eight domains (Communication with Doctors, Communication with Nurses, Responsiveness of Hospital Staff, Pain Management, Communication about Medicine, Cleanliness/Quietness of Hospital Environment, Discharge Information and Overall Rating) promise to impact the delivery of better patient-centered care. Five of these dimensions cluster together with Communication with Nurses leading the other four of, Responsiveness of Hospital Staff, Pain Management, Communication about Medication and Overall Rating.(3)

Hospitals and care delivery systems are uniting to achieve equity in healthcare to change care disparities and meet the needs of patients and the community. More and more nurses are called upon to think outside of the box. Asking questions opens possibilities and defines the essential role nurses serve in transforming the health care system.

So how will TCM model help in this united effort for patients?

In 2012, four education modules were developed to enhance TCM’s nurse caring attributes and improve caring perceptions of patients and families. Communication with Nurses is the number one attribute that functions like a ‘king pin” (the leader in the group or undertaking) for all caring behaviors. Participants were asked to complete the Caring Dimensions Inventory (CDI) of 25 aspects of nursing practice using the stem question, “Do you consider the following aspects ofnursing practice to be caring?” The CDI was first taken in as a pretest followed by 4.5 hours of education using four modules and followed by a posttest. The results indicated a change in the participants’ perceptions of affective caring dimensions to be significant and the changes in the technical dimensions approached statistical significance. The changes appeared to be in response to the education of participants. The attributes of nursing practice are both affective and technical elements of caring. For example, all participants considered “listening to the patient to beaffective caring. Participants who had been in a healthcare position (nurse, nursing assistant, or unit clerk) longer than three years had the greater perception change in mean scores post education. Further analysis with a larger sample size is planned in the future.(1)

The perceptions of caring are transferred by the nurse communication and actions of caring and compassion specific to the patient. The caring literature defines caring behaviors as including: attentive listening; making eye contact, touching, offering verbal reassurance;

putting the patient first; being physically and mindfully present; centering on the patient; responding quickly to patient needs; being emotionally open and available; being technically competent; and taking cultural differences into consideration. Caring by nurses is more specifically defined as anticipating needs, responding to requests, calming fears, willingness to help, promoting service, communicating effectively, explaining procedures, and concern shown by staff. Above all the caring relationship the nurse has with the patient and family is the most important. TCM provides the opportunity to understand and appreciate the value of their communication with the patient and family.(1-2)

Patient satisfaction has moved past customer service tasks to creating a patient experience and establishing a relationship. Nursing research studies and projects, like TCM, provide support to the importance of caring to sustain the human experience in care delivery regardless of the care delivery setting in which it is delivered. The four education modules to support the education framework for improving patient and family satisfaction include:

1. Concepts of Caring and Applications of Caring Theory

2. Caring Behaviors and Models of Nursing Practice3. Caring Environments and Workforce Engagement4. Outcomes of Caring, Consumerism, and Satisfaction

The modules may be taught individually or combined in a full-day retreat with focused educational experiences and application of TCM behaviors and caring enhancements to support the patient-family-nurse relationship initiatives within healthcare settings.

For further information or questions on this new aspect of TCM, please contact Dr. Dingman at [email protected]. or TCM®, 3052 N. Morning Mist Lane, Plain City, Utah 84404 or by phone at 940-395-5239.

References:(1) Dingman, S. K. (2012). Nurse caring enhancements

of the caring model®. Unpublished Doctor of Nursing Practice Project. Department of Nursing. Texas Christian University.

(2) Dingman, S. K., Williams, M., Fosbinder, D., & Warnick, M. (1999). Implementing a caring model to improve patient satisfaction. The Journal of Nursing Administration, 29(12), 30-37.

(3) Press Ganey Associates, Inc. (2013). The rising tide measure: communication with nurses. [White Paper].

(4) Wolosin, R., Ayala, L. & Fulton, B.R. (2012). Nursing care, inpatient satisfaction, and value-based purchasing. The Journal of Nursing Administration, 42(6), 321-325.

Nurse Caring Enhancements of the Caring Model® - Four Education Modules Describe a Patient-Centered Environment and the Value of

Nurse Communication to Improve Patient Satisfaction Outcomes

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Kathleen Kaufman, MSN, RN,President, UNA

Health care reform and the debate on whether to expand Medicaid and provide coverage for very low income adults has been a major issue in the Legislature this year – a major issue that has not been resolved yet again. As the Utah HospitalAssociation’sLegisLetter notes: “it is important toremember how far the discussion has come in the past year…while there was a lot of politics involved, there was also a lot of good discussion to find the right policy.” To be fair, many people from all healthcare professions worked at length on this issue during the session.

Two approaches to expanding or not-expanding Medicaid made their way through the legislature. In HB 141, Representative Dunnigan proposed that Utah would

NOT take any federal money, but would assist the poor with health care by using up to $30 million of scarce Utah funds to provide health care for the uninsured in the state. (If you divide this $30 million by the 54,000 Utahans proposed to be covered in some manner, this equals about $550 per person ---not even enough to subsidize the Utah Bronze plans.) This would provide far too little to an undetermined number of people in the state. No definite plan of how to allocate or spend these funds was described in the bill. While this bill did pass the House, it was amended to remove the language todevelopthis“AccessUtah”plan.(Thecarrierbill,HB141,was actually a bill to update various insurance statutes and HB 141 passed without involving the proposed coverage of uninsured Utahans.)

Senator Shiozawa sponsored SB 251 which, in essence, would accept the offered Medicaid funds from the federal

Medicaid Expansion Update, Again…

by Sharon K. Dingman, DNP, MS, BSN, RN – Chair, UNA Membership Committee

More than ever in our history as nursing in Utah, UNA has the opportunity and responsibility to assist its members (from the ground up) to achieve the continuous greatness of nursing in Utah. We have always sought a member-to-member relationship. Now is the time (2014) to reach out and accomplish a 100% contact with all of our members – current and future nurses. We all have much to offer as nurses individually and collectively to others in our “CARE” acrossUtah.Throughmembership inUNAwe can share our knowledge, compassion and caring for those we are called to serve as we walk (sometimes run) our chosen path as a nurse.

This year the UNA celebrates our 100th Anniversary – Together – Past, Present and Future. In the next few months all members will receive a Survey Monkey questionnaire seeking input on the value of UNA services, programs, and what motivates and prompts you and your non-member colleagues to join. We learn from the past, live in the present, and dream (plan) for the future. We will build on our history, share our present activities, and ask you to help strategically shape of future for UNA. Understanding your primary drivers of membership helps communicate the value UNA offers and what is unique about UNA

We sincerely invite your participation in this survey. Contemplate your primary reason for joining UNA and the affiliation with ANA. The survey questionnaire will ask this question. Research shows that the most common reasons cited for first joining a professional organization

Membership Present and Future of the Utah Nurses Associationare to realize personal benefits related to accessing job-related information, taking advantage of professional development opportunities, and networking with peers. Returning members who have gained experience place value on advocacy or foundation-related activities (1). You will assist in the defining of member benefits that are high drivers for membership at a nominal fee for the benefit.

The mission of UNA is to advocate, educate, and be a voice for all nurses in Utah both individually and as a whole by promoting and facilitating the roles and functions of nurses in all areas of employment and in all aspects of professional practice. Our goals are to speak through you with the goals of professional development of nurses and high standards of nursing practice. Ultimately, we all want the improvement and availability of health care and services for all individuals in Utah.

UNA objectives are to accomplish the mission and goals of UNA which include:

a. To promote established standards of nursing practice, education and nursing services.

b. To support the established ANA Code of Ethics for Nurses.

c. To provide for the professional development of nurses.

d. To support the system for credentialing in nursing.e. To support systematic study, evaluations, and

research in nursing.f. To Support the collection, analysis and

dissemination of information relevant to nursing in Utah.

g. To promote leadership in local, state, regional and national nursing issues.

h. To promote the principles of equality, fairness, safety and justice in the workplace.

i. To provide services and maintain communication with members.

j. To assume an active role as a healthcare consumer advocate.

k. To represent and speak for the nursing profession with allied health groups, local, state, and national organizations, government organizations and the public.

Opportunity to Get Involved: We are also seeking members for the Membership Committee across the state of Utah. Volunteers are needed that provide oversight on the membership in their local areas and to help us stay in touch with our membership. We would like to assign mentors to new members getting them involved in specific programs. This will be essential over the next three years to keep UNA active and thriving. The most important role of the Membership Committee is to have a plan in place for bringing in new members and getting them involved. If you are interested in being a team member of the Membership Committee, please contact: Lisa Trim @ [email protected] and cc Dr. Sharon Dingman, [email protected]

ReferencesJacobs, S. (2014). The art of membership: how to attract, retain,

and cement member loyalty. John Wiley & Sons, Inc. Published by Jossey-Bass, San Francisco, CA.

government to enable the uninsured who make up to 100% of the Federal Poverty Level (11,670/yr for a single adult) to buy insurance on the private market. This bill did not pass although Senator Shiozawa eventually amended the bill to more closely coincide with Governor Herbert’s interest in actually doing the same thing for all those who earn up to 133% of FPL ($15,521/yr for a single adult). The Governor is callinghisplanthe“HealthyUtah”plan.

Both Shiozawa’s and Herbert’s propositions will require a waiver from the Center for Medicare and Medicaid. While neither plan passed both House and Senate, the legislature also did not tie the governor’s hands in seeking more flexibility in Utah’s use of these Utah tax dollars currently being held by the federal government. Governor Herbert is pursuing some flexibility on the federal government’s part to use Utah’s Medicaid expansion dollars. He and his staff will be visiting Washington to pursue this objective in the form of a waiver. This may take some time and every month that Utah does not expand Medicaid costs the poor in our state some $4 million. Therefore, at this writing in mid-March, we have already lost nearly $10 million and by the time you read this in May, if the issue has not been resolved, we will have lost $16 million that we will never receive. How many people could have received quality health care for that lost funding? (If you want to watch the money being lost each day, visit the Community Cataylist’s countdown clock at: http://www.medicaidcounter.org/)

If you are interested in seeing your patients BEFORE they develop multi-system failure, undiagnosed diabetes, advanced cancer or other preventable conditions or conditions that could be detected by Medicaid-provided screenings, then discuss this issue with your representative and senator. If you want to learn more about Medicaid or its expansion, go to the Utah Health Policy Project website where the long history of Medicaid is provided in digestible articles spanning several years. Or join me at the Interim sessions of the Legislature to continue monitoring this issue.

Thanks to all members who have already contacted their legislators or the governor! You can contact your elected official more than once and remember that appropriations for implementation funds will be a real issue for many legislators. Please email Governor Herbert to thank him for devising a plan that may just meet the needs of our patients. If he is able to get the waiver to develop the “HealthyUtah” plan, there may be a special session called to ask the Legislature for the administrative funding to implement the plan. Keep an eye on the UNA website for updates.

References: 2014 Poverty Guidelines, US Department of Health and Human

Safety, retrieved from ASPE.hhs.gov/poverty/14poverty.cfm retrieved March 19, 2014

Stewart, K. (March 14, 2014). No deal reached on Medicaid expansion. Salt Lake Tribune.

Utah Hospital Association LegisLetter, retrieved March 18, 2014

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New Scholarship at Westminster Helps Nurse Practitioners Fulfill Their Passion

Paula Julander has not stopped fighting to help others—it’s the same strong characteristic often found in those studying to become nurse practitioners. Julander’s nursing career was the power behind her courageous insight, impact on the nursing profession, and is the impetus for the creation of the Paula F. Julander Endowed Scholarship for Nurse Practitioners at Westminster College. By easing the financial stress of those with similar aspirations, the scholarship will help make a postgraduate nursing education more affordable for those who otherwise may not be able to advance their education and career in the nursing field. Qualified recipients of this scholarship will include strong and determined students who are motivated to positively approach their world.

Along with the financial support that this scholarship provides, it reflects the story of a significant nurse role model – Paula F. Julander.

The endowed scholarship was established by Westminster College in appreciation for Julander’s lifelong career as a caring and successful nurse, nursing administrator, and Utah state senator. She wanted to provide financial assistance and encouragement to others seeking to pursue a career in this profession.

Paula JulanderSenator Julander has combined two separate professional paths in nursing and in

government. She used skills from each of these areas to build a career and show her passion for women’s health care reform

Raised in North Carolina, Julander co-founded American Laser Corporation. She brought her business with her when she moved to Utah in 1973. In 1984, Julander received her bachelor of science degree in nursing, graduating magna cum laude from the University of Utah. Six years later, she earned her master of science degree in nursing administration from Brigham Young University and was valedictorian of her graduating class. Julander served as a trustee of Westminster College from 1994-2002, and is now a trustee emeritus.

Government FocusWhat set Julander apart from other students was her participation in government. Even

before graduating with her master’s degree, she was a member of the Utah State House of Representatives, from 1989 to 1992.

She was an active member of the Western Legislative Conference for Health and Education and the Legislative Task Force for Health Care Reform in 1991 and 1992.

In 1992, she was the Democratic nominee for lieutenant governor in the State of Utah. Julander was also elected to the Utah State Senate in 1998 and re-elected in 2002 until 2005.

Nursing CareerWith more than 45 years in benevolent service as a nurse, she exceled in her career.

Julander served as the executive director of the Utah Nurses Association (UNA) from 1993 until 1998. In this capacity, she combined her legislative and nursing expertise by helping to meet the needs of individuals in the medical profession and in providing medical care for the noninsured and underinsured.

As a member of the Utah Women’s Forum, Women’s Political Caucus, the board of the Henry W. and Leslie M. Eskuche Foundation, and the board of Intermountain Health Care Hospitals, Julander is actively involved in the community and often speaks at health care conferences, workshops, and seminars.

She has received numerous awards recognizing her for her work and her passion for nursing, including the 1993 Community Service Award of the Sigma Theta Tau Honor Society of Nursing, the Susa Young Gates Award in 1991, and the Nurses Visible in Politics Award in 1989.

Her MotivationJulander has always been motivated to keep working and learning. In her career, she

has focused on the issues of education, family health, and crime.Through her role in government, she has championed women’s health care issues by

sponsoring legislation every session to benefit women and families.The powerful push needed for Utah’s most progressive nurse practitioner law in

existence in the United States today was through Julander’s lobbying efforts. She fought for the passage of the bill that created independent licensure for nurse practitioners in the State of Utah.

Westminster College Nursing ProgramFifteen years ago, Westminster created a Master of Family Nurse Practitioner degree.

The program offers working professional nurses the opportunity to become licensed and certified as an Advanced Practice Registered Nurse with prescriptive privileges as a Family Nurse Practitioner (FNP).

Westminster College offers graduate degrees in public health, nurse anesthesia, nursing education, and family nurse practitioner programs. At Westminster, students may also pursue graduate certificates in public health, family nurse practice, and nursing education.

The nursing program is accredited by the Commission on Collegiate Nursing Education (CCNE), and uses state-of-the-art facilities including pediatric and adult human simulator laboratories.

Areas of nursing study include pediatrics, critical care, obstetrics, community health, leadership/management, gerontology, psychiatric and medical/surgical nursing.

“Westminster’snursingprogramisdesignedtoaccommodatestudentsateverypointin life,” said Dr. Sheryl Steadman, dean of Westminster’s School of Nursing and Health Sciences.“Theprogramisforstudentswhodesiretoenteradynamicprofessionthatisexciting and touches people at the most important times in their lives. It’s for those who follow their passion.”

About Westminster:Westminster is a nationally recognized, comprehensive liberal arts college. With a

broad array of graduate and undergraduate programs, Westminster is distinguished by its unique environment for learning. Westminster prepares students for success through active and engaged learning, real world experiences and its vibrant campus community. Westminster’s unique location, adjacent to the Rocky Mountains and to the dynamic city of Salt Lake, further enriches the college experience. For more information, visit www.westminstercollege.edu or follow WestminsterSLC on Twitter.

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Pamela Farrell, MSN, RN, CRRN and Veronica Vilski, B.S.

Airline patrons have oftentimes witnessed the ease with which those around them –and even they themselves—fall asleep on the plane, even before the airplane is at cruising altitude. People of all ages begin to nod off as the plane gains speed and ascends into our atmosphere, mouths agape and heads tilted, bobbing to and fro. What is so comforting about napping in an airplane seat? Why the sudden wave of fatigue that causes many to catch a quick, or perhaps lengthy, nap?

Eve Van Cauter, an endocrinologist at the University OfChicago SchoolOfMedicine, has this to say. “…I findit amazing to see how many people are asleep within five minutes of boarding an airplane at 11 o’clock in the morning. You know, sit down and boom. It shouldn’t happen. A normal adult shouldn’t be falling asleep at 11 o’clock in the morning, minutes after sitting in a small, uncomfortable airplane seat. It just shows that, you know, people are exhausted.i”

WhenVanCauter notes that “people are exhausted,” she isreferencing sleep deprivation.

Perhaps you believe that you are not deprived of sleep. Perhaps you are among nurses and caregivers that think that you don’t need much sleep to function and even wear it as a badge of honor over those who need to get their eight hours of sleep each night. But are you also among the 29% of nurses surveyed in 2013 who have regretted some of the clinical decisions they made while sleep-deprived?

While not the only reasons for being sleep-deprived, the main contributing factors included sleep choices made while working 12-hour night shifts and facing less intershift recovery, resulting in greater sleep debt, and waketime sleepiness.ii

THE SCIENCE BEHIND SLEEPOur Sleep/Wake Cycle is the biological pattern of

alternating sleep and wakefulness - for example 8 hours of nocturnal sleep and 16 hours of daytime activity. The Circadian rhythm drives clear patterns of brain wave activity, hormone production, cell regeneration and other biological activities that are linked to the 24-hour cycle. While the body is sleeping, 20,000 neurons in the hypothalamus take in information on the day length from the retina, interpret it, and pass it on to the pineal gland, which then secretes the hormone melatonin to regulate sleep patterns.

Our sleep goes through cycles throughout a normal night’s sleep of seven to nine hours.

Throughout a normal night of sleep, your body will cycle through these five stages four or five times. If your REM sleep is interrupted, your next sleep cycle will go directly to REM until you make up the lost REM time.

Walking in Our Sleep: The Short and Long-Term Impact of Insufficient Sleep

Are nurses taking risks with their lives and the lives of their patients?THE ADVERSE EFFECTS OF SLEEP DEPRIVATION

So what happens when your sleep cycle is not able to function as it is intended? When lab rats were deprived of sleep, they died about as quickly as they would have died from starvation. This is how necessary sleep is to the life of every human. These rats started dying after just five days.i

The recommended amount of sleep for an adult is seven to nine hours of sleep per day. Any less than this amount of sleep is putting both a nurse and his or her patients at risk.

The negative effects of sleep deprivation are astounding and are attributed to many diseases. • Adultsmonitoredoveraspanofovertwoormoreyears

have shown to have higher blood pressure when they don’t receive enough hours of sleep.iii, iv

• Thereisanaverageof100,000accountsofcaraccidentsper year due to driving drowsy.v Drivers experience “micro-sleep,” a “brief transition from wakefulnessto sleep… [lasting] 20 or 30 seconds” that even occurs while one’s eyes are open and the person is functioning on autopilot.vi

• Sleepdeprivationhasbeentiedtomanypublicaccidents,such as the 1979 nuclear accident at Three Mile Island, the massive Exxon Valdez oil spill, the 1986 nuclear meltdown at Chernobyl, and others.vi

DavidA.Johnson,MDstatesthat“sleepdeprivationhasa profound impact on multiple disease states. For example, if you sleep less than six hours, epidemiologic studies show the following:• Strokeisincreasedbyafactoroffourtimes.• Obesityisincreasedbyanincreaseinghrelin,whichisa

hunger hormone. • Diabetesisincreasedbecausesleepdeprivationincreases

insulin resistance. • Memorylossisaccelerated.Epidemiologicstudiesshow

that there is not only permanent cognitive loss, but also evidence of early brain deterioration.

• Osteoporosis is increased, at least in an animalmodel.Another study even demonstrated changes in bone marrow within three months in a rat model.

• Cardiacdiseaseisincreased.Thereisa48%increaseinearly cardiac death, as well as increased cardiac-related mortality.

• Thereisafour-foldoverallincreaseinmortality.• There isan increasedriskforcoloncancer,andat least

one epidemiologic study shows an association between sleep deprivation and an increase in the likelihood of precancerous polyps.”vii

Specifically regarding nurses and their ability to perform their duties, the following statistics attest to the importance of sufficient sleep: • Even just one night of sleep loss causes particular

impairment to tasks requiring mental flexibility and the updating of plans when new information becomes available.viii

• Seventoninehoursofsleepisnecessarytoallowone’sbody to complete its sleep cycles and commit to long-term memory the new skills and information that was processed the previous day.v

• Whenvoluntary human test subjectswere placed in anMRI scanner and were shown increasingly negative andtroublingimages,“thosewithagoodnightofsleepshowed a nice, modest controlled response in their emotional centers of the brain.” But, when researchers looked at sleep-deprived subjects, they found “ahyperactive brain response…[and] a disconnect between that overreacting amygdala and the brain’s frontal lobe, the region that controls rational thought and decision-making, meaning that they subjects’ emotional responses were not being kept in check by the more logical seat of reasoning.”i

THE WAYS TO AID PROPER SLEEPIt is not always possible to avoid sleep deprivation.

Sleep deprivation is not always voluntary, but it still affects normal bodily function and it is still sleep deprivation. It doesn’t make any difference whether the loss of sleep comes from working nights, suffering from insomnia, being awakened by a crying baby, social activities, or a snoring partner.

The only way to solve the problem of sleep debt is by getting an adequate amount of quality sleep each 24-hour period. You cannot make up sleep debt on the weekend or weeks later. • Avoid napping during the day if it will disrupt your

nighttime sleep pattern. But, use naps as needed to reach your goal of 7-9 hours of sleep per day.

• Avoid caffeine, nicotine, andalcohol close tobed time.Although alcohol is seen as a way to lull oneself to sleep, it disrupts sleep in the second half of the sleep cycle as the body metabolizes the alcohol.

• Exercisevigorouslyduringtheearlypartsofyourwaketime, but choose a calming activity, such as yoga, before bedtime.

• Ensure adequate exposure to natural light duringwaketimes.

• Establish a bedtime routine and avoid emotionally-upsetting events near sleep time.

• Associate your bedwith sleep, notwatching television,listening to music, or reading.

• Keepyourroomasdarkaspossible.ix

Night shift workers have a harder time completing these sleep quality tasks. They are required to show more commitment to getting sufficient sleep. Thriving as a night shift worker takes self-discipline and commitment to oneself and the patients. The National Sleep Foundation has some advice for those with such a schedule. To stay alert through the night shift: • Avoidlongcommutesandextendedhours.• Takeshortnapbreaksthroughouttheshift.• Trytobeactiveduringquiettimes,forexamplewalking

or exercising.• Drink a caffeinated beverage (coffee or tea) to help

maintain alertness. Be cautious, though, that you don’t keep yourself awake with caffeine when it is time to sleep. Learn your body’s response to the volume of caffeine you choose to ingest.

• Don’t leave themost tediousorboring tasks to theendof the shift. Night shift workers are most sleepy around 4:00 or 5:00 AM.

• Exchange ideas with colleagues on ways to cope withproblems of shift work. Set up a support group to discuss the issues and learn from each other.

In order to sleep better during daylight hours:• Wear dark glasses to block out sunlight on your way

home. • Keeptothesamesleep/wakeschedule,evenondaysoff

of work.• Eliminate noise and light from your sleep environment

through use of eye masks and ear plugs or white noise machines.

• Avoidcaffeinatedbeveragesandfoodsclosetobedtime.• Avoidalcohol.x

The need for sleep is something that all animals share. Some animals sleep two or three hours a day and others sleep for twenty. Still others sleep with half of their brains at a time, all making it hard to figure out what exactly it is that makes sleep so essential and worth the evolutionary risks of being unconscious.i

The one thing that is certain, though, is that sleep is essential and affects our health, our emotions, and our mental and physical aptitude in ways which we have yet to discover. Adequate sleep is essential for you, your patients, your family, and the future of our society. A sleepless “badgeofhonor,”aclaimthatonedoesnotneedmuchsleepto function, is one that could end up bringing an untimely diseaseorevenanearlydeath.Mayour“badgeofhonor”be the boast that we have fulfilled our sleep needs and are performing at full capacity to better ourselves and those for whom we care.

Referencesi Science of Sleep. CBS News. June 12, 2008. ii Tired, Sleep-Deprived Nurses May Regret Clinical

Decisions. Medscape. Dec 30, 2013. iii Association Between Sleep and Blood Pressure in Midlife.

American Medical Association. Jun 8, 2009. iv Short Sleep Duration as an Independent Predictor

of Cardiovascular Events in Japanese Patients with Hyptertension. American Medical Association. Nov 10, 2008.

v 10 Things to Hate About Sleep Loss. WebMD. Feb 13, 2014. vi In the Blink of an Eye: Dozing while Driving. ABC News.

Dec 3, 2012. vii Fractured Sleep Exacts a Heavy Toll. Medscape. Feb 19,

2014viii One night of sleep loss impairs innovative thinking and

flexible decision making. PubMed. 1999 May;78(2): 128-45 ix Sleep Hygiene. National Sleep Foundation. Spring 2003. x Shift Work and Sleep. National Sleep Foundation. 2005.

• Early Phase •Beginsasthesunsets•Brainrelaxesandslows down•Alphawavesare produced•Experiencevivid sensations and myoclonic jerks

• Still relatively awake and alert•Increasedbloodflowto muscles•Releaseofhormones for cell growth•Ifwokenfromthis stage, one feels groggy and disoriented

•Stage 1 •Thetawaves•Lightsleep•Lasts5-10minutes•Whenwokenfromthis stage, one might say they weren’t sleeping although they looked the part

•Stage 4•Deltasleep•Lasts30minutes•Necessarytofeel refreshed and satisfied•Bedwettingandsleep walking occur at the end of this stage

•Stage 2•Temperaturelowers•Heartrateslows•Lasts20minutes•50%ofsleepisspentin this stage

•Stage 3•Deltawaves•Transitionfromlight sleep to deep sleep•Bodybeginsits restorative functions

•Stage 5•RapidEyeMovement (REM) stage•Dreamingoccurs•Voluntarymuscles become paralyzed•Increasedrespiratory rate and brain activity•Begins70-90minutes after falling asleep•Lastsashortamount of time at first, but later stretches to 60 minutes


2013 AANP Advocate State

Award for Excellence

AUSTIN, TX (June 21, 2013). The American Associat ion of Nurse P r a c t i t ione r s (A A N P) recognizes outstanding achievements of individuals in each state who have made a significant contribution toward increasing awareness and acceptance of the NP role. Dr. Leissa Robert was awarded the 2013 AANP Advocate State Award for Excellence. She developed a clinical service within Utah’s juvenile justice system to provide comprehensive care to incarcerated adolescents. The care in this unique clinic is provided solely by NPs. The sites are also utilized by nurse practitioner students as a part of their educational training and also provide a venue for NP students to work with a diverse patient population.

Dr. Roberts is a doctoral prepared Certified Nurse Midwife who has been faculty at the University of Utah College of Nursing since 1993. As a clinician, she is committed to advancing support with attention to cultural and personal values. She is a clinical expert of woman’s health care and obstetrics and field of women’s healthcare with the nurse-midwifery philosophy that focuses on the needs of the individual and family for physical, emotional and social specializes in young woman preventive healthcare.

As the Assistant Dean of Faculty Practice, she is responsible for facilitating interdisciplinary models of care and development of new faculty practice sites. Dr. Roberts oversees 10 faculty practices and is responsible for the 37 faculty in those 10 practices. She has increased revenue generation from Faculty Practices from $500K per year to over $3.5 million per year. She has strategically guided the growth of BirthCare Health Care Faculty Practice from 1 to 4 outpatient sites and has increased births from 175/year to 500/year.

In an effort to more fully leverage the diverse strengths of its 250-plus advanced practice clinicians for the promotion of collaborative teams and quality care, University of Utah Health Care (UUHC) has established the Advanced Practice Clinician (APC) Council. Comprised of 14 advanced practice clinicians from throughout the UUHC system, the APC Council is working to be a collective voice for UUHC’s advanced practice clinicians, which include nurse practitioners (NPs), certified nurse midwives (CNMs), physicians assistants (PAs) and certified registered nurse anesthetists (CRNAs). Dr. Roberts was selected to serve as the council’s chair.

Dr. Roberts is the Primary author of the Coping with Labor Algorithm© a new tool which replaces the old 1-10 NRS in pain evaluation for the laboring woman. The Coping with Labor Algorithm has been accepted by The Joint Commission, the licensing body for hospitals nationwide, and it has become the standard at the University of Utah and is widely utilized in hospitals throughout the United States and in five countries. She is also the creative vision behind the Sutter Health College of Nursing partnership which has led to over 40 graduate assistant positions for CON students.

Dr. Roberts received the prestigious 2013 Individual Contribution to Maternal Child Health Award from the National Perinatal Association.

Leissa Robert

Are You Interested in Forensic Nursing?NEW course design reduces class room time to 3 days

Adolescent and Adult Sexual Assault Nurse Examiner Course

DATES: August 14, 15 & 16, 2014Blanding, UT

TUITION: $60 40 contact hours pending approval through Utah Nurses Association

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This course meets all requirements established by the International Association of Forensic Nurses in didactic training as an Adolescent – Adult Sexual Assault Nurse Examiner. This didactic material is required for those interested in sitting for national certification examination in Adolescent – Adult Sexual Assault Nurse Examiner. Clinical experience is also required before applying for the certification examination. This training is open to any registered or advanced practice nurse with an interest in forensics and sexual assault. For further information contact: Dianne Fuller [email protected]

Using on line modules, a nationally developed virtual SANE DVD and classroom time with a skills day, this course will provide the basic didactic and clinical information to begin the process of becoming a sexual assault nurse examiner (SANE) for adolescent and adult victims. Registration required by August 1, 2014 to allow time to complete on-line module component of course.

This course has also been approved for 2 graduate level credits from the University of Utah through the College of Nursing and Department of Continuing Education. There is an additional $40 fee for these credits.

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Sharon Palmer passed away on October 17, 2013. Sharon received a BS in Nursing from Weber State University graduated Suma Cum Laude. She was working on her Master’s Degree in Nursing when she passed away. She worked at Davis Hospital as one of the House Supervisors on night shift. She was a tremendous nurse and loved all those she worked with and the patients she served. Her calling in life seemed to be centered on caring for others. She loved being a nurse.

Lyall McDonald passed away December 22, 2013. Lyall went on to graduate from the Holy Cross School of Nursing as an R.N. She worked as an R.S. in the Salt Lake City LDS Hospital.

Lear Pace passed away December 23, 2013. Lear graduated from the Salt Lake General Hospital nursing program, she was a RN for over 40 years.

Sherry Shaffer Cummingham Jackson passed away January 2014. Sherry returned to school and received her LPN nursing degree in 1971. She worked in the emergency room at South Davis Hospital and then as a surgical nurse at Lakeview Hospital for 35 years until she retired.

Jeanmarie Goodman passed away January 21, 2014. After graduating from Ricks College she began a 30-year career in nursing, where those who received her care often described her as an angel. She truly loved her work “family”atPioneerValleyHospital.

Glenna Mae Driggs Klein passed away January 19, 2014. She had a long career as a nurse at Primary Children’s Hospital.

Bonnie Louise Bullock passed away January 19, 2014. Bonnie went on to study nursing at St. Josephs, was one of the first to attend classes at Western Wyo Community College. Graduated at University of Wyo and did graduate work in public health at University of Utah. She retired from the Salt Lake County Health Dept. after bringing in many new programs that are still in use today.

Opal Nancy Rowley-Bush, LPN, passed away, January 16, 2014. She honorably served in the United States Navy Medical Corps.

Ione Callahan passed away January 22, 2014. Ione was a passionate nurse with a long and distinguished career in nursing with a degree from Westminster College. She became one of the youngest supervisors at St. Marks Hospital running the Orthopedics and Psychiatric wards. She worked as a Director of Nursing at the Duluth Clinic and South Davis Community Hospital and also as a hospice nurse. She loved her time as a school nurse in the Davis County School system.

Margaret Eklund passed away January 26, 2014. Margaret graduate from Holy Cross School of Nursing in 1955. Received a B. S. in Nursing from St. Mary’s College in Notre Dame, Indiana and a M.S. in Public Health Administration from BYU. She taught at St. Mark’s School of Nursing and worked in communicable diseases at the Salt Lake Health Department. In 1994 she was the third recipient of the Public Health Nurse of the Year Award.

Scholarship Information

If you are interested in applying for the Utah Nurses Foundation Scholarship, please go to www.utahnursesassociation.com. On our website you will need to click on Scholarships and there you will find the information you will need to apply or contact us by email [email protected].

• Scholarships must be postmarked by June 1 or October 1 of each calendar year to be considered.

• Applicantswill receive notice of theBoard’s recommendations by July 15 and October 15 of each calendar year.

• Recipientsareonlyeligibletoreceivescholarships twice.

• Applicantsmustabidebythecriterialisted within the application.

IN MEMORIAM

Holy Cross Sister M. Ann Patrice passed away December 29, 2013. She enrolled in the Holy Cross Hospital School of Nursing in Salt Lake City. She became an RN in 1944 and went on to receive a bachelor’s degree. In 1940 she entered the Congregation of the Sisters of the Holy Cross and in 1942 began 46 Happy years in the hospital ministry in Utah and California, including 10 years at Holy Cross Hospital in Salt Lake City.

Leona Decker passed away February 1, 2014. In 1966 Leona graduated with a nursing degree at the Salt Lake Community College. She worked as a nurse for 20 years in labor, delivery, pediatrics, and on the psyche ward. She was known for her compassion when helping patients.

Joan Davis passed away February 13, 2014. Joan attend nursing school at Weber State, received her RN degree on June 10th 1983. She worked as a community nurse for many years, always becoming very close friends with her patients.

Josephine A. O’Hara passed away on February 17, 2014. She received her Nursing degree from St. Mary’s Hospital School of Nursing, in Rochester, MN. As a Diploma Nursing Recipient, she was proud to be a mentor for young nurses and those interested in the field of nursing. She specialized in the field of psychiatry and substance abuse. Josephine was well known in the medical community in Salt Lake City. She was her Director of Nursing at Highland Ridge Hospital and Wasatch Canyons Hospital, and the Quality Assurance Coordinator on Inpatient Behavioral Health at LDS Hospital and Intermountain Healthcare.

Mary Elizabeth Seegmiller passed away February 19, 2014. She graduated from the University of Utah with a Bachelors and Master’s degree in Nursing. She worked for many years as a registered nurse.

Constance Simmonds passed away February 2014. She graduated from St. Elizabeth’s School of Nursing in 1945, where she served as Class President. She was a dedicated and caring person, and had a successful and long-lasting career as a nurse at St. Marks Hospital. She retired from nursing in 1983.

Jacqueline Arlene Smith passed away February 11, 2014. She attended Nursing school at the Salt Lake Area Vocational School. She worked as a LPN at Salt Lake County Hospital, LDS Hospital, and Pioneer (Valley West) Hospital.

Janis Lyn Motoki passed away March 16, 2014. In 1977 she graduated from the University of Utah with a Bachelor of Science degree in Nursing. Her career began at the Labor & Delivery Ward at LDS Hospital where she worked for several years.

Connie Sims passed away March 18, 2014. Connie spent her entire life taking care of others. She started her career as an RN with the VA Hospital and continued her education while expanding her career earning two masters degrees, participating in medical research studies and teaching nursing so that others could benefit from her experiences and knowledge. In later years while working as a nurse practitioner, she focused on specialty care of patients in a home setting and promoting alternative natural treatments for pain and chronic conditions.

DirectorofNursingandAlliedHealthFull time (12 month) with a competitive benefit package

$75,000 DOE, Open until filled

• Current,active,unencumberedRNorAPRNlicenseormultistateprivilege to practice nursing in Utah

• Atleastthreeyearsofexperienceteachinginanaccreditednursingeducation program

• KnowledgeofcurrentLPNpractices

IfyouareexcitedtoshareyourknowledgewiththeUBATCstudents,andyouareinterestedinafull-timeteachingpositionwithexcellent

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Roosevelt Campus

We salute all nurses during National Nurses

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APRN Positions AvailableImmediate opportunity for full-time and competitive contract APRN positions to work in Salt Lake County at Valley Behavioral Health clinics providing psychiatric care and prescriptive services for a population of adults with serious and persistent mental illness. Must be confident, adaptable, vibrant and inspired by working in this exciting and cutting-edge field of psychiatry.

Work as a member of supportive, multi-disciplinary teams providing a full continuum of care. Generous benefits package. Must be licensed in the State of Utah as an A.P.R.N. and current DEA certificate.

To apply, go to www.valleycares.com and apply for Job #APRN.

For more information contact Dr. Thatcher, Medical Director,

Valley Behavioral Health at 801-263-7107.

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Utah Navajo Health System, Inc.

We are a not-for-profit Community Health Center providing medical, dental and behavioral health care in neighborhoods throughout the northern portion of the Navajo Nation and southeastern Utah. We provide primary health care to men, women, and children, regardless of citizenship status, nationality or ability to pay.

To view current openings and apply online, visit

www.unhsinc.org

557W.WASHINGTON•BURNS,OR97720•541-573-7281•www.harneydh.com

Rural Hospital RNJoin our high caliber staff of RN’s and live in the beautiful high desert of Eastern Oregon! 25-bed Critical Access Hospital seeks licensed RN for full time position. Broad training opportunities to facilitate your growth as a quality RN. Small patient to nurse ratio and great medical staff who complete our care team. Prefer experience in med/surg, ER or OB. Salary $28.98-44.24 DOE + night and weekend differentials. Call Denise Rose Harney District Hospital 541-573-5184 or apply at harneydh.com.


With more than 80,000 RNs, APNs, LPNs/LVNs and nursing assistants, VA is the Nation’s largest employer of nurses. Join us in serving those who have unselfishly served our country.

At VA, you’ll be given the tools and training you need to provide our Veterans with the best care possible. You will have the chance to participate in research initiatives focused on enhancing health and preventing disease among our Nation’s heroes. And, you’ll be able to further your career through our various nursing leadership and clinical development programs.

What’s more, you will have the freedom to practice at any one of the over 1,400 VA medical facilities throughout the 50 states, the District of Columbia, and other U.S. territories—with only one active state license.

George E. Wahlen VA Medical Center

VA nurses earn a competitive salary, plus many other benefits:• Generous annual and sick leave accrual • Shift/Weekend Differentials • Pension and Matching Funds for TSP (similar to 401k)• 10 Paid Federal Holidays a year• Health, Dental and Eye Benefits

For more information, contact Daniel Fale, BSN, RNPhone: 801-582-1565 ext 1128 or email [email protected]

George E. Wahlen, VAMC (118)500 Foothill Drive

Salt Lake City, UT 84148

I’m not just a nurse.

I’m inventing a new model of health care.

nursing.byu.edu

Brigham Young University College of Nursing

Faculty Positions Available• Doctoral degree in nursing is preferred (PhD or DNP)• Salary / rank commensurate with experience and qualifications• Apply online at yjobs.byu.edu and send letter of interest to:

Dean Patricia K. Ravert, BYU College of Nursing, 500 SWKT, Provo UT 84602

BYU is an equal employment/affirmative action employer, sponsored by The Church of Jesus Christ of Latter-day Saints. Employees are required to observe Church standards.

Master’s Graduate Program:Family Nurse Practitioner (FNP)

• Post-master’s certificate also offered

• Preceptors providedfor clinical experiences

• Ranked in top graduateschools in the nation by U.S. News & World Report

• Scholarships and other financial aid available

• Questions? (801)422-4142 [email protected]

Documents

Inside Utah Nurses Association Centennial Celebration ... · Centennial Celebration: 1914-2014 Friday, October 10, 2014 Salt Lake City, UT The Utah Nurses Association will celebrate