The off ic ial Publ icaT ion of The alaska nurses associaT ionPB

www.aknurse.org

The Official Publication of the Alaska Nurses Association. Circulation 9,000.

Distributed to every Registered Nurse and Licensed Practical Nurse in Alaska.

THE

Volume 66, Issue 2April/May 2015

Professional Pride

The off ic ial Publ icaT ion of The alaska nurses associaT ion2

2 President’s Letter 3 Legislative Fly-In 5 APRN Alliance Update 6 AaNF Grant Applications 6 On Writing: Just Do It 7 Calling All Nurse Writers 8 A Caring Heart 10 Patient Safety Pt. 3

12 APRN Bill Introduced 12 Snowmachine Injuries 12 PRN Negotiations Begin 15 Alaska Kidney Walk 15 Calendar of Events Insert Nurses Week Celebrations Insert Jobs at AaNA

some of you are thinking I’m a bit obnoxious. But hey – being a nurse is a BIG DEAL! Not everyone can do this. It’s about time we recognize this and realize that the key to being recognized as a professional is to own it and apply that word to ourselves. I feel that we have to view ourselves as professional before anyone else will. For many of us, being a nurse is not just a job, but a calling. I worked hard to become a nurse. Today, nurses are college-educated professionals that complete a difficult curriculum which requires many hours of clinical time above and beyond all the studying, homework, and class time required by other degree programs.

The requirements of my job are multifaceted. I need to have technical knowledge to effectively manage the machines and gadgets of my profession. I need to have working knowledge of anatomy, pathophysiology, and pharmacology. I need to have effective communication skills to educate my patients about complex health concerns. I need to have a strong body to be able to be on my feet 12 hours per day and to perform strenuous tasks such as turning, repositioning, or lifting patients. I may have to push a bed or stand in a less-than-optimal position for long periods of time as I hold pressure on a

THE OFFICIAL PUBLICATION OF

THE ALAskA NuRsEs AssOCiATiON3701 E Tudor Rd., Ste. 208 • Anchorage, AK 99507907.274.0827 • www.aknurse.orgPublished bimonthly: Feb., April, June, Aug., Oct., Dec. Materials may not be reproduced without written permission from the Editorial Committee: Contact editor@aknurse.orgAdvertising: salesaknursepub@gmail.com • 907.223.2801

AaNA BoArd of directors • President: Jane Erickson, ADN, RN, CCRN• VicePresident: Arlene Briscoe, RN-BC• secretary: Phi Tran, MSHS, BSN, RN • treasurer: Jennifer Hazen, BSN, RN• staffnursedirector:• ruraldirector: Nelly Ayala, MSN, RN• Greateralaskadirector: Juanita Reese, BA, BSN, RN, CEN• laborcouncilchair(desiGnee): Donna Phillips, BSN, RN• directorsatlarGe: Shelley Burlison, RN-BC Janet Pasternak, BA, BSN, RN Paul Mordini, MS, BSN, RN-BC Kimberly Kluckman, RN Lila Elliott, BSN, RN• studentnurseliaisons: Leanne Pizzi – UAA Teresa Beitel – Charter College

Aanalaborcouncil• chair: Donna Phillips, BSN, RN• Vice-chair: Jana Shockman, RN, CCRN-CSC• secretary: Danielle Heyl, BSN, RN• treasurer: Jennifer Hazen, BSN, RN • directors: Arlene Briscoe, RN Lila Elliott, BSN, RN Jane Erickson, ADN, RN, CCRN Kimberly Kluckman, RN• PaMcbureP: Jennifer Hazen, BSN, RN• soldotnabureP: Shelley Burlison, RN-BC• ketchikanbureP: Susan Walsh, RN• affiliateorGanizations: Alaska Affiliate of the American College of Nurse-Midwives Alaska Home Care & Hospice Association Alaska Association of Nurse Anesthetists Alaska Nurse Practitioner Association Alaska School Nurses Association Alaska Clinical Nurse Specialist Association

authorGuidelinesforthealaskanurseThe Editorial Committee welcomes original articles for publication. Preference is given to nursing and health-related topics in Alaska. Authors are not required to be members of the AaNa.forMatandsubMission: Articles should be Word documents in 10 or 12 point font, single or double spaced. There is currently no limit on the length of the article. Include the title of the article and headings if applicable. Author’s name should be placed after the title with credentials, organization and/or employer and contact information. Authors must identify potential conflicts of interest, whether of financial or other nature and identify any commercial affiliation if applicable. All references should be listed at the end of the article. Photos are encouraged and may be sent as a .jpg file, as an email attachment or on disc. Photographs send to the Alaska Nurse will become property of the AaNA. We hope that we will be sent copies, not originals, and prefer emailed files. Photos should be provided with a caption and photo credit info and be high resolution. Be sure to double check the spelling, grammar, and content of your article. It is highly recommended that you have a colleague review your article before submission. Prepare the article as a Word document and attach it to an email to andrea@aknurse.org. You may also mail the article on disc to: the Alaska Nurse, aana,3701etudorroad,suite208,anchorage,ak99507. If you have any questions, please email andrea@aknurse.org.

President’s LetterJana Shockman, RN, CCRN-CSC Alaska Nurses Association Past President • Anchorage, AK

by Jana Shockman, RN, CCRN-CSC Alaska Nurses Association Past President

These last couple months have been a whirlwind for the AaNA as an organization. Our Ketchikan Nurses bargaining unit has successfully negotiated a new contract, our Providence Registered Nurses bargaining unit is entering negotiations, we held our Nurses Legislative Fly-In to Juneau, we are actively filming continuing education webinars, and much more. Whew!!!

As we’ve gone through all these activities and events, I’ve come to realize that we as nurses have a problem. It’s an insidious little thing that creeps up on us. It usually occurs when someone asks, “What kind of work do you do?” A frequent reply (and the insidious little thing of which I write) is: “I’m just a nurse.”

JUST a nurse? Seriously, every time I hear “I’m just a nurse” I have to contribute to the swear jar. If nurses want to have the professional respect of our peers, our patients, and other professional groups, we have to start thinking of ourselves as professional.

If you’ve been reading my president letters, you know that I am passionate about my profession; possibly to the point that

Inside This Issue4 8 10 11

coverPhoto:AaNA President Jane Erickson (center) and AaNA Charter College Student Nurse Liaison Teresa Beitel (left) meet with Representative Shelley Hughes in Juneau during the annual Nurses Legislative Fly-In (see page 4).

THE ALASKA NURSE • ApR iL/MAy 2015The off ic ial Publ icaT ion of The alaska nurses associaT ion2 3

www.aknurse.org

Located in beautiful Southwest Alaska, in the town of Dillingham, BBAHC has many employment opportunites. Come and enjoy the Alaska Native Cultures of the Aleut, Eskimo and Indian. Our town is 2,460 strong and we serve a 44,000 square mile region of 34 villages with a total population of 8000.

Please contact Human Resources at (907)842-5201 or by email at personnel@bbahc.org or refer to our website at

www.bbahc.org for more information

BBAHC is an equal opportunity employer operating under the Alaska Native and American Indian Preference in Hiring provisions of PL93-638. Pre-employment drug screening and a completed background investigation and determination that the applicant meets the eligibility criteria of the Alaska Barrier Crimes Act and, where applicable, the Indian Child Protection Act, are prerequisites to hiring.

EMPLOYMENT OPPORTUNITYBristol Bay Area Health Corporation

www.bbahc.org

On behalf of the Alaska Nurses Association, I would like to thank Ms. Jana Shockman for her service to the Association as President of the Board of Directors and acting Director of Professional Practice. Her input on nursing issues was always well-educated and thoroughly researched. Her service to the Association will be truly missed. We wish Ms. Shockman well in her professional and educational endeavors. Thank you, Jana.

-- Jane Erickson, President, AaNA Board of Directors

bleeding wound or assist with a procedure. As a bedside nurse, I need to understand what is going on with my patient at all times and be attuned to subtle changes in that patient’s condition. I need to know how to intervene on my patient’s behalf, whether that means calling the physician, adjusting a medication, plumping a pillow, or holding the hand of a frightened patient or their loved one.

The public has a certain perception of nurses and what we do. Nurses are consistently rated as the most trustworthy profession. Nurses are held to high standards and work within specific scope of practice regulations and statutes. We hold ourselves to high standards as well. If you visit any professional nursing organization website and look for the organization’s core values, the list will vary a bit, but will consistently include: honesty, responsibility, belief in human dignity, desire to alleviate human suffering, pursuit of knowledge, and professionalism.

There really is no reason to question whether or not nurses are professionals, yet for some reason, many nurses simply don’t step up and own that title. We must work together and encourage each other to stop thinking of ourselves as “just a nurse.”

We are not “just nurses.” We are nurses! We are professionals. We are making differences in the lives of our patients. We have a voice in directing our practice at the bedside and at the healthcare policy level. It’s up to us to own it and make the most of our profession. When I say “I am a nurse,” it means so very much to me. I accept the responsibility of what it means to be a nurse when I say “I am a nurse.” I say it with professional pride. I say it with passion. Do you?

The off ic ial Publ icaT ion of The alaska nurses associaT ion4

It’s a Record:35 Nurses Flock to Juneau for Legislative Fly-In

by Arlene Briscoe, RN-BC

The Alaska Nurses Association is back from our annual Nurses Legislative Fly-In to our capitol city. A record 35 nurses traveled to Juneau, representing seven nursing groups from across the state. The feedback after our visit was (as it always is) “lots of fun.” I can’t disagree with that.

Meeting up with old friends and making new friends is exciting. Hopping on a plane and heading out of Anchorage for a few days gets me out of my routine. Staying in a hotel and eating in new restaurants is always fun. A walk around our quaint and tiny capitol city takes one through some of our state’s oldest history. Juneau’s art shops, gift stores, and shoe store – you shoe addicts know who you are – add an eclectic and enjoyable vibe to the trip. It is also an athletic endeavor, with steep hills and staircases that seem to go on forever. You never know who you will meet on the streets. One evening on my way back from the capitol building I ran into our Lt. Governor, Byron Mallott! I love Alaska; where else can one just walk along and bump into the Lt. Governor? No security crew, no press – just another Alaskan.

However, I really want to add that it isn’t just fun. It is also hard work. Most nurses who go to Juneau for this event travel on their own

dime. Weeks of preparation are undertaken getting familiar with nursing issues, researching and rehearsing positions. Nurses learn about the legislators representing their districts, preparing for intense twenty-minute visits with their senator and representative or staff.

Our day at the capitol is a long one. We begin early: a 7:00 AM breakfast and training session with our lobbyists, Caren Robinson and Mark Hickey. They fill us in on our schedules for the day, etiquette for meeting and interacting with our legislators, important updates on current issues, and a stern reminder: be on time! After that, it is a bracing walk up the hill and the day begins in earnest. We were welcomed warmly by everyone we met. Appointments were scheduled throughout the day from 8:00 AM to 5:00 PM. Individuals and groups met with their legislators and were free to attend other appointments with other legislators. Many bills and interests that impact our state were discussed: including environmental toxins, mental health legislation, workers’ compensation, voluntary termination of life, regulation of smoking, and yes, even daylight savings time! Many of us were able to sit in on committee meetings and sessions of the Senate and House of Representatives,

as well as Senator Lisa Murkowski’s annual address of the State Legislature.

The Nurses Legislative Fly-In, coordinated by the Alaska Nurses Association, included seven groups representing RNs and APRNs in Alaska: Alaska Nurses Association, Alaska Nurse Practitioner Association, Alaska Affiliate of the American College of Nurse-Midwives, Alaska Clinical Nurse Specialist Association, Alaska Association of Nurse Anesthetists, Alaska School Nurses Association, and Alaska APRN Alliance.

Current issues of interest receiving widespread attention in the Legislature include regulation of marijuana, the state budget, Medicaid expansion. Other important issues include a prescription drug monitoring program, fair audit for pharmacies, and immunization without collaboration, which would allow licensed pharmacists to prescribe and administer vaccines to persons aged 3 and up without needing a prescription from a licensed prescriber.

The Alaska APRN Alliance and Alaska Nurses Association are working diligently to lobby for and pass Senate Bill 53, an act updating statutes regulating APRN nomenclature. Find out more about the bill on page 12.

THE ALASKA NURSE • ApR iL/MAy 2015The off ic ial Publ icaT ion of The alaska nurses associaT ion4 5

www.aknurse.org

The Denali Center is hiring for heart. We seek CNAs, LPNs, and RNs to provide nursing care in our loving, compassionate environment where both residents and staff are encouraged to live fully and to learn and grow.

Our award winning home-like environment promotes happiness by fostering relationships amongst residents, staff and volunteers.

If this is an environment where you would feel at home, please visit our website for a complete list of current openings.

A GOLDEN OPPORTUNITY— DENALI CENTER —

TO APPLY VISIT: BANNERHEALTH.COM/CAREERS

Administrative Assistant Sr.Supports the Chief Nursing Officer (CNO), Administrators, or members of facility senior leadership teams by providing clerical and administrative services and assistance, requiring the use of judgement and discretion on a periodic basis.

Administrative Assistant Sr.Supports the Chief Nursing Officer (CNO), Administrators, or members of facility senior leadership teams by providing clerical and administrative services and assistance, requiring the use of judgement and discretion on a periodic basis.

The Denali Center is hiring for heart. We seek CNAs, LPNs, and RNs to provide nursing care in our loving, compassionate environment where both residents and staff are encouraged to live fully and to learn and grow. Our award winning home-like environment promotes

happiness by fostering relationships amongst residents, staff and volunteers.

If this is an environment where you would feel at home, please visit our website for

a complete list of current openings.

It’s a Record:35 Nurses Flock to Juneau for Legislative Fly-In

APRN Alliance 2nd Annual Legislative and Pharmacology Updateby Laura Sarcone, RN, ANP, CNM

On January 10, 2015 fifty-two advanced nurse practitioners (soon to be “advanced practice registered nurses”) gathered at the BP Energy Center for the APRN Alliance 2nd Annual Legislative and Pharmacology Update.

Laura Sarcone ANP, CNM gave a brief history of the Consensus Model for APRN Regulation. The APRN Alliance and the Board of Nursing are working together to bring Alaska statute into compliance with the Consensus Model.

Legislation that would change their statutory title from “advanced nurse practitioner” to “advanced practice registered nurse” has been introduced. Denise Valentine ANP, chair of the Board of Nursing and Senator Cathy Giessel ANP discussed specific issues related to the bill and the process of getting a bill passed into law.

An important part of this legislation will change our current “authorization” to “license” to practice. There were some in the audience who were surprised to find out that their advanced practice is not already “licensed!”

Dr. Sherry Richey gave a great talk on “Treating Chronic Diseases in Pregnancy” and Dr. Benjamin Westley’s presentation on Hepatitis C was full of the most recent research and treatment approaches.

This event was made possible through financial support from the Alaska Nurses Foundation and the Alaska Nursing Action Coalition. The Alaska Nurse Practitioner Association and the Alaska Nurses Association, through their logistic support, also contributed to a very successful conference. The APRN Alliance wishes to recognize and thank planning committee members Chris Logan CRNA, Carrie Doyle CNS, Kathrine Hardy ANP, Heidi Koslo ANP, Elizabeth Smaha ANP, Heather Palmer CNM, Tracey Weise ANP, and Theresa Isaac.

The off ic ial Publ icaT ion of The alaska nurses associaT ion6 The off ic ial Publ icaT ion of The alaska nurses associaT ion6

By Sandra Woods, MS, RN President, Alaska Nurses Foundation

The Alaska Nurses Foundation was established in 1998 following an insurance settlement between the Public Health Nurses of Southeastern Alaska and Premera Blue Cross in the late 1980’s. The founding members were from across nursing disciplines and across the state. The interest from that investment account provided the money for any Alaska nurse to apply for a grant in four (4) categories: Clinical or Community projects, Individual continuing education, Publications and Research, and Workshop delivery to support clinical, educational and scholarly projects designed to promote the profession of nursing in Alaska or promote the health of Alaskans. The grant committee looks for opportunities to support nurses across the state, not just the urban centers. In fact, recent grants have been for rural communities.

Grant applications and information can be found on the Alaska Nurses Association website at http://www.aknurse.org/index.cfm/about/award-opportunities. Sandra Woods, President and Tina DeLapp, Treasurer, are available to answer questions or provide assistance with your application.

For the 2014 grant applications, the Foundation expanded the membership category to include the Alaska Professional Nurses Organization to meet one of the grant requirements. Nurses may also be members of the Alaska Nurses Association or the Alaska Public Health Association, and must also be members of the Foundation. Alaska Nurse’s Foundation membership dues remain $20 annually. The Foundation is a recognized 501 c 3 non-profit so donations of any amount are tax deductible. If you don’t normally “join” organizations or associations, consider a donation to support nursing research and education in Alaska.

The grant recipients for 2014 were:From the General Nursing Fund- Laura

Sarcone was awarded $500 to support the Professional and Clinical Updates for Nurse Practitioners Conference.

From the Public Health Nursing Fund- there were 2 grants awarded-

Nelly Ayala was awarded $3200 to fund implementing the 4th R Curriculum for Domestic Violence Prevention in Naknek.

Susi Peterson was awarded $3329 to fund Indoor Gardening to Promote Healthy Eating on the North Slope.

Previous grant recipients include Maria Sistrom deValpine, 2012, for her research and article Bristol Bay Living Nurses; Zienna Blackwell, 2012, Bethel, to cover the cost of converting their very successful Kids in the Kitchen program to combat childhood hunger and obesity into an online delivery format to make it accessible to communities across the state; Colleen McNulty, 2013, to partially cover speaker expenses for the 2014 Public Health Nurse conference; and Lindy Ferguson, 2013, Juneau, to fund Health Food, Healthy Kids, to prevent childhood obesity and promote healthy nutrition.

Nurses submitting 2015 grant applications must be members of the Alaska Nurses Foundation AND members of one or more of the following organizations: the Alaska Nurses Association, the Alaska Public Health Association, and the Alaska Professional Nurses Organization. Alaska Nurse’s Foundation membership dues remain $20 annually. The Foundation is a recognized 501 c 3 non-profit so donations of any amount are tax deductible. If you don’t normally “join” organizations or associations, consider a donation to support nursing education and nursing research for your colleagues and community. The Foundation is exploring several options to make donations easier and electronic so stay tuned for updates.

We also invite you to follow us on FaceBook- https://www.facebook.com/alaskanursesfoundation/

Get Ready!Alaska Nurses Foundation Grant applications due August 1st

On Writing:Just Do itBy Maureen Shawn Kennedy, MA, RN AJN Editor-in-Chief

This article first appeared in American Journal of Nursing, Volume 114, Issue 10, Page 7 and is reprinted with permission from Lippincott, Williams & Wilkins and Wolters Kluwer Health.

thebestwaytobecomeawriteristowrite.Nurses often tell me “I wish I could write” or “It

must be nice to be able to write.” This reflects the common, but flawed, belief that people who write are born writers. But a person is no more born a writer than born a nurse. Such thinking belies the fact that education plays a part – that in writing, just as in nursing, knowledge and skills must be acquired and then practiced in order to maintain competency. Writing can be taught and learned, although as with any field of expertise, some people will become more proficient than others.

Nurses who find writing hard might be surprised to know that even professional writers and editors struggle when facing a blank page. Some of my colleagues, whose journals either publish every two months or don’t feature editorials at all, have looked at me in horror when I tell them I write a monthly editorial for AJN. For me, writing is hard work. And yes, my work is edited; I answer queries from my editor and make revisions based on her suggestions. No one gets it right on the first try.

One key to becoming a good writer – or a good anything – is persistence. Over the years, AJN has published many articles on writing for publication, and most offer variations on this theme: you have to work at it. For example:• from a 1953 column by Dorothy Deming, a

former editor of Public Health Nursing: “The more you write the easier it gets. The point is to write. Don’t wait for a free evening on your vacation.”

• from a 1977 editorial by former AJN editor Thelma M. Schorr: “Perhaps the most basic precept is that to learn to write, you must write. And write. And write.”

• from a 1994 column by Shirley Fondiller, a former adjunct associate professor at Columbia University’s Teachers College: “[W]riting is a craft. You need to keep cultivating and refining your writing skills, and you can only do that if you keep writing.”

A good basic approach, and one that works for me, involves four steps. First, spend some time thinking about what you want to say before you start writing. Know what you want to tell readers – the purpose of your paper – so that you can say it

THE ALASKA NURSE • ApR iL/MAy 2015The off ic ial Publ icaT ion of The alaska nurses associaT ion6 7

www.aknurse.org

The off ic ial Publ icaT ion of The alaska nurses associaT ion6

E-cigs. Not harmless. Not healthy.

What’s in the cloud?Nicotine — Addictive Ultra-fine particles — Asthma

Formaldehyde — Embalming fluid

Acetone — Nail polish remover Lead — Brain damage

alaskaquitline.com

Sources: 1. Schripp, T., Markewitz, D., Uhde, E. and Salthammer, T. (2013), “Does e-cigarette consumption cause passive vaping?” Indoor Air, 23: 25–31

2. Williams M, Villarreal A, Bozhilov K, Lin S, Talbot P (2013) “Metal and Silicate Particles Including Nanoparticles Are Present in Electronic Cigarette Cartomizer Fluid and Aerosol” PLoS ONE 8(3): e57987

clearly. Next, sit down and start writing. Write anything you want to say about the topic; you can go back and organize later. (Contrary to what many of us were taught, you don’t have to outline first. Some writers write this way, but many don’t.) Third, leave the work alone for a while. Take a walk or do something else. And fourth, go back and start shaping and polishing your piece, paying attention to organization and transitions. Aim for a logical flow of ideas. Weed out the jargon, too.

At the August meeting of the International Academy of Nursing Editors, I attended a session on overcoming barriers to writing given by Donna Nickitas, editor of Nursing Economic$ and a professor at the Hunter-Bellevue School of Nursing, City University of New York, and Joy Jacobson, codirector of a narrative writing program for health care professionals at Hunter College’s Center of Health Media and Policy and adjunct faculty at the Hunter-Bellevue School of Nursing. (Jacobson, a former managing editor at AJN, also currently does freelance writing for this journal.) They offered strategies designed to prevent that “How am I going to fill this page?” block. One recommendation: plan a time and place for daily writing, even if it’s only 15

minutes. Having a set time and place provides structure and routine, and will make writing seem less like an onerous chore and more like a familiar habit. Once you begin, you can always write for a longer period.

Nickitas and Jacobson also recommended keeping it simple: start anywhere, but start. And keep your hand moving, whether you’re using a pen or a keyboard. Whether it’s because of muscle memory or the mind-body connection, this works. Random thoughts will morph into coherent sentences, which you’ll later organize into paragraphs; before you know it, you’ll have 500 words and good start to a short essay or an article.

In her 1977 editorial, Schorr spoke further of keeping the end goal in mind. The writer “will use the active voice and not shirk his [or her] responsibility by introducing a statement with such weaseling qualifiers as ‘It is considered that…’ or ‘It is generally believed that…’ [and] will never let secondary motivations, like trying to sound scholarly or contemporary, obscure what must be his [or her] basic purpose in writing: to communicate.” Nurses have incredible stories to tell, and much knowledge to communicate. Let yourself start scribbling!

Calling All Nurse Writers! Have you ever wanted to write about a subject that you are passionate about? The Alaska Nurse Editorial Committee is looking for nurses to help plan issues, write articles, conduct research and interviews, and share bright ideas. This is a fantastic opportunity to have your voice heard and your work featured in a publication. Contact Andrea Nutty at andrea@aknurse.org or907-274-0827 if you are interested in submitting work or participating in the Editorial Committee!

The off ic ial Publ icaT ion of The alaska nurses associaT ion8

By Phi Tran, MSHS, BSN, RN Secretary, AaNA Board of Directors

Why did you choose to be a nurse? What makes nursing special? Isn’t it hard work? How’s the pay and is it worth it? These are some questions that I often encounter when someone finds out I love my job as a nurse. Born in Vietnam, I came to the US with my family when I was 12 years old. My parents have always encouraged my siblings and I to excel in our education, with my father emphasizing the importance of the medical field. He would emphasize it, because it was a means to not only care for one’s self but anyone else, anywhere and anytime.

After 10 years in the nursing field, I still love my job. I love that there’s so many different areas in the nursing field and that the skills are so universally vital. To be a good nurse though, one must have a caring heart and a willingness to care for others regardless of their situation. I realize that nursing standards are very different depending on which country one is in. There is a lot of room to improve in this field. There is also a nursing shortage currently, so a handful of people enter nursing not for the right reasons. This is why I’m going to emphasize the importance of caring and tell you how I came to this conclusion.

I have had the privilege of joining the Embedded Team Training (ETT) while being on deployment in Kabul, Afghanistan in 2008. In this position, I would work closely with the Afghan National Police and Afghan National Army nursing forces. In Afghanistan, the people have other concerns that supersede job, family and money. The primary concern being safety - who is the enemy, where there may be bombs, how one would commute around and the safety for oneself with those

they interacted with. While I was there, I met about 100 individuals who claimed to be nurses and were taking care of patients in the local hospitals and clinics. Our team convoyed out in Humvees to the medical facilities daily to assess, evaluate and plan various medical training. I realized the immediate need to emphasize on hand washing, infection control, wound care, dressing changes, patient assessment, correct vital signs, and patient education. There was a need to clarify what truly defined someone as a nurse. Then if someone was a nurse, what their mission and vision would be. During my six months in the country, I had the opportunity to work closely with the Afghan nursing staff and translators to present briefings, share my nursing skills, and work along with the staff to care for the Afghan patients. I assisted the staff in understanding the joy and pride of the nursing field. Those that stood out the most to me and the patient were those who were willing to learn and cared about their patients. One could see the appreciation from the patients and their families when the nurse spent an extra minute to care for them.

Another experience I recently had was traveling to Phnom Penh, Cambodia to volunteer at a Children’s Surgical Center. I was blessed to be introduced to this opportunity and served with Dr. Winkle, a retired Army ophthalmologist. Within one week, we saw over 50 children and adults in the clinic who needed check-ups and assisted with various eye surgeries. These patients and their families traveled hundreds of miles to the city to be seen in this no-cost hospital. The nursing staff worked hard to assist the surgeons and patients to provide the best care they could. I worked with the local staff in the recovery stage after surgery was done. This was challenging because of our lack of supplies, especially airway supplies and pain management medication. The nursing staff of Cambodia were eager to learn and assist as needed. It was amazing to see family, who without much knowledge and training, were so involved in the care of their loved ones. It was nice to see family and nursing staff working together, with the minimal resources at hand, to care for the patients, as best as they could. The nurses who stood out and blessed those patients the most

would be those who have a kind heart and truly listened to the needs of the patient and family. As I struggled to communicate and navigate a different country and their systems, I realized that my touch and my smile were much needed as part of the nursing care to these patients and families. The patients and family just appreciated that I cared despite the language barrier. Our nursing expectations and standards are very different when compared to the United States, but we managed to make it work and the key all seemed to be in the caring aspect.

At home in the United States, I’m blessed to be able to practice my nursing skills in numerous areas and to be among people who uphold the highest nursing standards that so patients get the best care possible. Within the past 10 years, as a nurse, I have worked in the Medical Surgical Pediatric Oncology Unit, Gastroenterology Clinic, Pediatric Clinic, Same Day Surgery, Recovery Room and convalescence rehabilitation center. I have had the privilege to care for the military servicemen and their families, veteran and retiree, civilians, Afghans, Cambodians and many more. All these interactions have been very rewarding because regardless of where or when, I am helping someone in the time of need. The patients and their family are at the most vulnerable moment. I know a caring touch, soft smile and a nod often helps them stay strong and fight another day.

Nursing Starts with a Caring Heart

THE ALASKA NURSE • ApR iL/MAy 2015The off ic ial Publ icaT ion of The alaska nurses associaT ion8 9

www.aknurse.org

Samuel Simmonds Memorial Hospital (SSMH) in Barrow, Alaska is a facility unlike most others; it is located in the northernmost city

of the United States and serves a population that spans across a region larger than the state of Washington.

Serving the North Slope, a region that is colored by rich cultural diversity and beauty of the Inupiat people, Samuel Simmonds Memorial Hospital works to

reserve the health of the region as well as the culture. By joining SSMH, you’ll be embarking on the adventurous journey as enriching as it is

rewarding. Here you’ll have the unique opportunity to provide healthcare to a vibrant community ready to share its culture and heritage. More than a once in

a lifetime opportunity, you’ll provide care in a small community environment, partner with a familial, professional sta� , and truly touch—and be touched

by—the Inupiat people. It’s an experience you won’t forget. So join us today!

visit us: www.arcticslope.org

Samuel Simmonds Memorial Hospital is an eligible IHS loan repayment site. For more information visit www.ihs.gov

Now recruiting for the following positions:» Inpatient Med/Surg» RN Case Managers » RN Phone Advice» Emergency» LDRP/OP

Phone: 907.852.9204Mail: PO Box 29, Barrow, AK 99723

Fax: 907.852.3365 | hr@arcticslope.org

A rewarding career in the northernmost cityA rewarding career in the northernmost city

is closer than you think

NSRH is a Joint Commission accredited facility with 18 acute carebeds, 15 LTC beds serving the people of the Seward Peninsula andBering Straits Region of Northwest Alaska. New hospital now open!

I’ll admit I do not know all the science behind every illness or have memorized the detailed information on all the medications, but I know where to find the resources and provide care to my patient safely. During my experience, one quote has been told to me numerous time: “People don’t care how much you know, until they know how much you care.” I’m not sure who originally said this, but I find it very true. There are a lot of smart people in the world, but in the end – caring and relationships are what binds us.

Nursing will never make me super wealthy like a billionaire, but I didn’t go into it for that. Nursing is a rewarding field. The ability to care for someone’s life or those they love in the time of need: you can’t measure that in monetary worth. A great nurse is someone who is kind and cares for others starting from his or her heart! Because I know the different nursing standards and practice through my experience in various countries I happen to be in, I strongly encourage everyone to continue to take the time to travel and help others. It really opened my eyes to the needs of others and that to be a good nurse, one just needs to care. Hopefully, through one’s actions, others may be inspired and this will help the nursing field continue to excel. I love nursing because I have the skills to take care of myself, those I love and others in the time of need. It’s a big world out there, even if one doesn’t know all the clinical knowledge, just start caring, and you’ll be on your way.

The off ic ial Publ icaT ion of The alaska nurses associaT ion10

by Carlie Holmberg, RN, CPHQ and Lynette Savage, PhD, RN, CPH

Airplanes and Patients: What is the Connection?

For more than 20 years, experts have compared aviation and healthcare.

Why? The reason is simple, airplane crashes kill

people and healthcare kills people.

Still not seeing the connection?Human factors cause planes crashes

and deaths; human factors cause medical mistakes and deaths. The connection is a call-to-action. The aviation industry assessed their weak processes meant to minimize human-err factors and adopted a strong culture of safety. The number of plane crashes fell while healthcare related injuries and deaths increased.

Need more?As soon as the aviation industry

identified the relationship between human errors and airplane crashes, it launched a huge culture shift to standardize processes, improve crewmember communication, and save lives. Airplane Captain Chesley B. “Sully” Sullenberger, the Hero-on-the-Hudson noted in a speech fourteen months after his ‘successful’ plane crash, “The risk of accidental death in a jet aircraft from 1967 to 1976 was 1 in 2 million. Today, it is 1 in 10 million. After 75 years, we in aviation have benefited from lessons learned at great cost, literally bought in blood, lessons we now offer up to the medical field for the taking” (O’Reilly, 2010, para. 5). Nurses know that patients are not airplanes, yet the dramatic shift in the aviation safety culture shows us that it is possible to save lives.

Health care has not uniformly adopted the seemingly simple safety culture elements and standardized practices required to cease medical mistakes and save lives. Nance (2009) believes that “medical mistakes are merely human mistakes committed within a human system inadequately designed to catch and neutralize those mistakes in time” (p. 29).

The Joint Commission (2014) reports that the single most significant trend found from sentinel events continues to be a lack of communication between team members. “It is thought that half of adverse events in surgery are avoidable and ‘the majority’ are due to poor communication, decision making and teamwork” (Smith, 2014, para. 2).

No longer do aviation employees assume their leaders are omnipotent and infallible. Prior to the aviation culture shift, senior pilots were not questioned. The Tenerife Disaster, which killed over 500 people, is a primary example of this. The accident was linked to communication failures and a pre-existing hierarchy amongst the crew (Kilroy, 2013). Jacob Van Zanten, a well-respected and senior pilot, without question from the crew, attempted to take off. The plane crashed into another plane still on the runway. The final conclusion from the investigation found that Van Zanten was solely responsible for the accident. Human error.

That incident forced aviation safety experts to focus on human error and communication as a systemic problem rather than as an individual problem. The causes of airplane crashes are often linked to human error. Yes, in fact, to err is human.

The horrifying realities for healthcareLeapfrog Group’s Hospital Safety Score

Website reports:• Asmanyas 440,000 people die every year

from hospital errors, injuries, accidents, and infections

• Everyyear, 1 out of every 25 patients develops an infection while in the hospital, an infection that does not have to happen

• AMedicarepatienthasa 1 in 4 chance of experiencing injury, harm, or death when admitted to a hospital

• Todayalone,morethan 1,000 peoplewilldie because of a preventable hospital error

It is important to remember that most

hospital errors can be prevented. Nurses and other healthcare professionals work hard every day to protect their patients from errors, injuries, accidents, and infections, yet errors continue to occur at alarming rates (Leapfrog Group, 2014). A large part of making healthcare safer comes from changing the existing culture.

Nursing students dig deeper into the connections

An Anchorage cohort of five University of Great Falls RN-BSN students collaborated on a leadership project during the summer of 2014. These nurses studied the concepts surrounding aviation and healthcare safety. They looked to John Nance as a leader in patient safety.

John Nance is a captivating international speaker on healthcare safety. He is also a commercial pilot. As a founding board member of the National Patient Safety Foundation, he is also touted as a pioneer and advocate for the aviation safety revolution. Nance was pivotal in developing Crew ResourceManagementprinciplesandAirForce human factors flight safety education.

He is the author of many books, journal articles, and newspaper articles. His well-known book Why Hospitals Should Fly is published in 32 countries and 18 languages.Mr.Nanceandhiswife,KathleenBartholomew,MN,RN,alsoarecognizedauthor and leader in patient safety, are an inspirational duo focused on improving healthcare.

On July 7, 2014 the Anchorage BSN students had a unique opportunity to speak with the couple on the telephone. These leaders offered to speak with the students while they were traveling. From an airport in Idaho they answered questions and shared their views about healthcare, leadership, and safety culture. It was sixty exciting minutes of captivating and inspirational discovery.

Patient Safety Series Part III:For the Love of Nursing

THE ALASKA NURSE • ApR iL/MAy 2015The off ic ial Publ icaT ion of The alaska nurses associaT ion10 11

www.aknurse.org

Johnnanceandkathleenbartholomewleavealastingimpression

From that interview with Nance and Bartholomew several themes emerged: • In patient centered care, the patient is the

subject of care, not the object• Human-designed systems are inadequately

designed to catch and neutralize errors• Perpetual perfection is fraud, we

(healthcare) must build resilient processes• Leadership must create the conditions that

extract, orchestrate, and inspire human talent

• Hospital C-Suites (referencing administration, e.g. Chief Operating Officer, Chief Nursing Officer, and Chief Medical Officer) must be willing to dismiss those individuals threatening safety with their hierarchical attitudes

• Another must: reducing variation, increasing standardization, allowing for communication as equals, and an opportunity to speak up to the “captain of the plane”

• Nursing leadership is where the rubber and the road come together, a human interface with the patient with pathos and emotion

The epilogue in Bartholomew’s book (2014) captures the ‘call-to-action’ for nurses. Bartholomew – always an educator – has provided four nursing contact hours with the book. She writes about a metaphor that holds the essence of nursing’s collective dilemma.

“One day a nurse was walking by a river and she saw a person calling for help in the water. Immediately she waded in and pulled her out and bandaged the leg of the bleeding woman. But no sooner had she finished attending to her needs than she heard another person calling for help, then another.

She called for her friends and more nurses came to the rescue, frantically pulling injured

people out of the turbulent waters. Not only did the numbers of victims increase, but the severity of their wounds did as well; so she called for the doctors. Day in and out for weeks the nurses and physicians kept saving the lives of the river wounded. Weeks turned into months; years turned into decades and everyone was utterly exhausted.

And then one day without any warning, a single nurse stood up and started walking away from the river. Suddenly, like a swarm of swallows, thousands of nurses stood up and followed her as she walked away from the river of illness and disease. ‘Where are you going? You can’t leave!’ shouted a doctor, desperate and panicked.

Just then, the very last nurse turned back to him and shouted, ‘We’re going to see who’s throwing these people down the river.’

It is time to leave the river; time to stop protecting our individual fiefdoms of professionalism and gather like moths to the flame around the value that nursing brings to our society. This coming together of like minds begins by supporting and nurturing the people we work with every day. Healing our world begins by caring for ourselves and each other with the same loving devotion that we administer to our patients.

This is our Crimean War. But because the battlefield is all around us, it is difficult to perceive exactly what we are fighting, and so, many of us are constantly drawn down to the river. If three million nurses stopped drinking bottled water or eating fast food; or demanded nurses in every school; or that the FDA address the use of hormones, antibiotics and pesticides in our food supply, the number of sick people in our river of illness would decrease exponentially. This is how we can leave the paradigm of disease – and take our

patients with us.

We have both an opportunity and an ethical obligation to come together in an unprecedented way to restore the health of our nation. Every individual action will either bring us closer, or farther, from this goal. To that end, I hope this book has served you well.

For the love of nursing, Kathleen”

If you were to ask one of the students today, they would tell you that there is a lot of work still left to be done. They would tell you that frontline nurses need to speak up about hostile environments created by those few rotten apples. They would comment on the critical role that nursing leadership plays in establishing care processes aimed to prevent harm. They would say that patient safety is similar to an incredible collaborative dance of many. Like a precision-line, one misstep off the choreographed plan can cause disaster.

The students quickly realized their concept of patient safety would permanently change. A flattened hierarchy now made perfect sense, yet none of them had experienced it. Listening to these passionate leaders discuss healthcare transparency, authenticity, accountability, and culture sparked a fire within them that continues to burn.

For the love of nursing, let us come together and begin to change our culture.

References:Alamy (2014). Photograph from Surgeons are to be tested on ‘people skills’. The Telegraph. Retrieved from http://www.telegraph.co.uk/health/healthnews/11048950/Surgeons-are-to-be-tested-on-people-skills.html

Bartholomew, K. (2014). Ending Nurse-to-Nurse Hostility: Why Nurses eat their young and each other. (2nd ed.). Danvers, MA: HCPro.

Flacy, M. (2012). Photograph from Airline pilot distracted by new text messages botches landing attempt. Retrieved from http://www.digitaltrends.com/mobile/airline-pilot-distracted-by-new-text-messages-botches-landing-attempt/#ixzz3TSNtmOAO

Kilroy, C. (2013). Special report: Tenerife. Retrieved from http://www.airdisaster.com/special/special-pa1736.shtml

Leape LL. (1994). Error in medicine. JAMA. 272(23):1851-7.

Leapfrog Group (2014). Errors, injuries, accidents, infections. Retrieved from http://www.hospitalsafetyscore.org/what-is-patient-safety/errors-injuries-accidents-infections

Nance, J. J. (2009). Why hospitals should fly. Bozeman, MT: Second River Healthcare Press.

O’Reilly, K. (2010). Patient safety: What can medicine learn from aviation? Retrieved from http://www.amednews.com/article/20100614/profession/306149945/4/%29

Smith, R. (2014). Surgeons are to be tested on ‘people skills’. The Telegraph. Retrieved from http://www.telegraph.co.uk/news/health/news/11048950/Surgeons-are-to-be-tested-on-people-skills.html

The Joint Commission [TJC] (2014). Advancing effective communication, cultural competence, and patient-and-family-centered care. Retrieved from http://www.jointcommission.org/Advancing_Effective_Communication/

The off ic ial Publ icaT ion of The alaska nurses associaT ion12

by Andrea Nutty

On February 18th, 2015 during the annual Nurses Legislative Fly-In, registered nurses from across the state looked on as Senate Bill 53: “An Act Relating to Advanced Practice Registered Nursing” was introduced in the Alaska Legislature. Sponsored by Senator Cathy Giessel, a nurse practitioner representing Senate District N, the bill aims to align Alaska statute with a national movement called the APRN Consensus Model.

The APRN Consensus Model standardizes titles for advanced practice registered nurses, or APRNs. Promulgated by the National Council of State Boards of Nursing, the Consensus Model seeks uniformity in APRN licensure, education, accreditation, and certification. The four existing APRN specialties would all be included under the title of Advanced Practice Registered Nurse in this statutory update: Certified Nurse Practitioners, Certified Nurse-Midwives, Certified Registered Nurse Anesthetists, and Certified Clinical Nurse Specialists.

Currently, advanced practice registered nurses in Alaska are divided into two statutory groups: Advanced Nurse Practitioners and Nurse Anesthetists. The statutory group of “Advanced Nurse Practitioners” includes nurse practitioners, nurse midwives, and clinical nurse specialists; while nurse anesthetists are recognized under a different category. The approximately 1,000 advanced practice registered nurses that practice in Alaska would be affected by this change.

Why make a change at all? Advanced Nurse Practitioner (ANP) and Nurse Anesthetist (NA) are outdated mechanisms of categorizing advanced practice registered nurses. In Alaska, these titles are 34-years-old. As more states adopt the national APRN Consensus Model, these titles will become increasingly outdated. Furthermore, “ANP” does not accurately reflect the education or

title of certified nurse midwives or clinical nurse specialists. This is potentially confusing to patients and in usage outside of Alaska.

The APRN title is also now used by many insurance companies, the VA, and Medicare. Adopting this title in Alaska should work to expedite insurance reimbursement by eliminating confusion over service providers. This uniformity will also boost patient understanding of the APRN roles, allowing patients to better participate in their healthcare. It will also allow APRNs from other states to more easily obtain Alaska nursing licensure. Uniformity in licensing means more healthcare providers for Alaska and increased access for patient care.

Importantly, Senate Bill 53 would not change scope of practice. Alaska’s advanced practice registered nurses will continue to provide the same high quality, safe, accessible care they have provided to Alaskans across the state for 34 years; they will just have a new name: APRN.

Following its introduction on February 18th, Senate Bill 53 was referred to the Senate Labor and Commerce and Health and Social Services Committees. On March 13th, Senate Bill 53 was heard in the Senate Labor and Commerce Committee and was referred to the Senate Health & Social Services Committee. In Labor and Commerce, Senators Costello, Giessel, Meyer, and Stevens signed “do pass.” A date for a hearing in Health and Social Services for Senate Bill 53 will be posted at www.aknurse.org.

To view the full text of Senate Bill 53 and to view related documents, visit http://www.legis.state.ak.us/basis/get_bill.asp?bill=sb%20%2053&session=29.

To support Senate Bill 53, keep up-to-date on the bill’s progress, or participate in other legislative activities, contact AaNA Legislative Chair Arlene Briscoe at arlene@aknurse.org.

Alaska APRN Consensus Model Bill Introduced

current Alaska statute

Proposed statute change

Snowmachine Injuries: Prevention is keyby Elizabeth Campbell, PhD, MSN, FNP, CNE

A young boy was out snowmaching with his father when he fell into a moulin, or deep hole in a glacier caused by water being transported from the surface of the glacier to the base. The young boy was killed when the snowmachine landed on top of him.

At about 7:30 one evening, a village woman was struck and seriously injured by a snowmachine operated by a fourteen year-old driver with a 13 year-old passenger. The woman had been drinking home brew, was intoxicated, and decided to walk outside, collapsing about 400 yards away. The driver did not see her in time to avoid striking her.

Background According to the International Snowmobile

Manufacturers Association, one of the first versions of the snowmachine was built in the 1930s, carried up to 12 people, and was in demand by doctors and veterinarians. In the late 1950s, smaller gasoline engines made the recreational use of snowmobiles possible. In 2014, there were over 54,000 snowmachines sold in the United States, and more than 52,000 were registered in Alaska during the 2013-2014 season (2014).

In Alaska, the snowmachine (or snowmobile as it’s called in other parts of the country), is not only a source of recreation, but the most prevalent form of motorized winter transportation in rural areas. A large portion of the population lives in remote areas. Usually, these areas have limited road access, requiring the use of off-road motorized vehicles as the primary form of transportation (Snyder, Muensterer, Sacco, & Safford, 2014). Significant mortality and morbidity among both adults and children are associated with the use of snowmachines (DeCou et al., 2003). People riding on or operating a snowmachine are more than eight times higher than those driving a car, to be injured or killed (McGhan, 2014). Alaska averages nearly one snowmachine-related death every week in the winter and for every death, ten Alaskans are injured requiring hospitalization. If snowmaching was an occupational hazard, its associated fatality rate would outrank that of aviation, commercial fishing, and logging (Joling, 2001).

Because of the reliance on snowmachines in remote villages, Alaska Natives are at greater risk of snowmachine related injuries than non-Natives (Landen, Middaugh, & Dannenberg, 1999). One out of three snowmachine related fatalities are juveniles, passengers or pedestrians. The death rate for men is three times greater than women (Gubler, 2014).

THE ALASKA NURSE • ApR iL/MAy 2015The off ic ial Publ icaT ion of The alaska nurses associaT ion12 13

www.aknurse.org

We have openings available for the right candidates.No weekends, no on-call responsibilities, competitive salaries and bonuses. Sign-On bonuses may also be negotiated.

Applications are being accepted for RN’s to fill Recovery Room, Pre-op, and Stage II Post-op levels of care. Because we are an outpatient ambulatory facility, our patients are typically healthy and do not require intensive nursing care that are seen commonly in full in-patient hospital environments. This creates a pleasant work environment with low stress.

For RN’s interested in periodic work, we have occasional overnight observation patients that require nursing during those stays. If you would be interested in being on our list of float pool for those occasional overnight patients, please call us.

If these opportunities sound interesting to you, please visit our website at www.scfairbanks.com or call Rudy Martinez at 907-350-4306.

Fairbanks’ First and Only Dedicated Outpatient Surgery Center

MechanismofinjuryThe most common mechanism of injury

in snowmachine crashes is blunt force trauma resulting in head and spinal cord injuries during collisions with objects such as trees, cars, other snowmachines, moose and snow berms. Crashes may result in rollovers leaving the driver and passenger thrown or pinned under the machine. Internal injuries and traumatic asphyxiation may also result from blunt force trauma.

Another mechanism of injury often resulting in death is drowning and associated exposure and hypothermia. Falling through thin ice is a real threat, particularly in late fall and early spring.

Being caught in an avalanche is yet another threat to recreational snowmachine users. In fact, snowmachine users are more likely than skiers or snowboarders to be killed by avalanches. Since 1998, 86% of those killed by avalanches in the Chugach National Forest were snowmachiners (Wright, 2014).

risk factorsThere have been many factors identified that

contribute to injuries from incidents related to snowmachines. One factor that has been clearly documented is the use of alcohol. One study found that 65% of all fatal incidents involved the use of alcohol, although this could be much higher (Medred, 2010). The use of alcohol and other drugs may cause operators to ignore basic safety principles, as well as impair judgment and slow reflexes (Gustafsson, & Eriksson, 2014).

The lack of helmet use is another significant risk factor. Children from remote communities are less likely to wear helmets, while Alaska Native children are five times less likely than children of other ethnicities to wear helmets (Snyder, Muensterer, Sacco, & Safford, 2014). With no helmet law, it is difficult to encourage helmet use when riders self-report the lack of use due to: user discomfort, the lack of perceived risk associated with not using helmets, inconvenience, and the challenge of acquiring child-sized helmets in remote areas (Snyder et al., 2014).

Snowmachine incidents resulting in injury are most likely to happen during hours of darkness, weekends, and holidays (Sy, & Corden, 2000). Snowmobile-related deaths most frequently occur from October to May, with the highest number occurring in April. In the spring, increased daylight and warmer temperatures may increase the risk of falling through melting, thin ice. Also, after a winter’s use of trails, the snow becomes packed down, which allows the operation of snowmachines at higher speeds (Gustafsson, & Eriksson, 2014).

Inexperienced drivers and poor decision making also contribute to wrecks. Yet another risk factor is children operators who may not have the strength and manual dexterity to operate a large,

(See Snowmachine page 14)

The off ic ial Publ icaT ion of The alaska nurses associaT ion14

powerful machine, nor the mental cognition needed to make judgments about operation when challenged (Wyrick, & Maxson, 2014).

One person was killed and another seriously injured when two snowmachines plowed into the same snow berm. The first struck the berm at a high rate of speed, which propelled the snowmachine and the driver into the air, traveling approximately 55 feet. The driver died at the scene. A second machine, with a driver and a passenger, hit the same berm, ejecting both. The driver was uninjured, but the passenger was airlifted due to the severity of the injuries suffered. In addition to alcohol and high speed being factors in the crash, no one was wearing helmets.

PreventionPrevention of snowmachine injuries

is a multidimensional approach. Laws and regulations such as those related to helmet use and operator age restrictions may be considered. Modifications to the design and engineering of snowmachines to make them inherently safer (such as limiting speed) are options. However, due to public opinion, lack of oversight, and the difficulty in enforcing laws, the above-mentioned suggestions could be difficult to implement.

The following is a list of prevention strategies that may prevent snowmachine injuries. Healthcare providers may include the following information when educating patients. Due to the unique qualities of Alaska, some may be more appropriate than others.• Don’t drink alcohol and drive• Always ride with someone else• Wear appropriate gear including helmets,

chest plates, and floatation devices• Wear appropriate insulated, protective

clothing including goggles, and rubber-soled boots

• Recreational use of snowmachines by children and adolescents should be avoided

• Know the condition of the ice before traveling on it

• Drive at appropriate speeds for conditions• Drive on established and marked trails; not

on public roads, railways, or bodies of water• Always use headlights and taillights• Slow down when approaching the top of a

hill• Check the weather before traveling• Don’t carry more than one passenger per

snowmachine• Travel in daylight whenever possible• Always carry safety equipment including a

first aid kit, a survival kit, flares, a cellphone, a tent, dehydrated food, a chainsaw, and a SPOT (a transceiver that sends out GPS coordinates alerting emergency responders)

improvetrails,addmarkers,andusewarningsigns

The National Avalanche Center, the Canadian Avalanche Center, and the International Snowmobile Manufacturer’s Association have developed an educational campaign designed to prevent deaths from avalanches (Wright, 2014). The five core concepts are:1. Get the Gear: Ensure everyone has an

avalanche transceiver, shovel, and probe on person and knows how to use it

2. Get the Training: Take an avalanche course3. Get the Forecast: Make a riding plan

based on current avalanche and weather forecasts

4. Get the Picture: If you see recent avalanche activity, unstable snow exists

5. Get Out of Harm’s Way: Don’t go to help your stuck friend. One at a time on all avalanche slopes

conclusionAs devastating as snowmachine injuries

can be, the good news is that the majority can be prevented. Healthcare professionals are in perfect position to help reduce injures by educating people about the risks related to snowmachine use and by modeling safe behavior.

referencesDeCou, J., Fagerman, L., Ropele, D., Uitvlugt, N., Schlatter, M., & Connors, R. (2003). Snowmobile injuries and fatalities in children. Journal of Pediatric Surgery, 38(5), 784-787.

Gubler, K. D. (2014). Snowmobile-related injury. American College of Surgeons. Retrieved November 20, 2014 from https://www.facs.org/quality-programs/trauma/ipc/snowmobiles

Gustafsson, T., & Eriksson, A. (2014). Off-road vehicle fatalities: A comparison of all-terrain vehicle & snowmobile accidents in Sweden. IATSS Research, 37, 12-15.

Hoey, J. (2003). Snowmobile injuries. Canadian Medical Association Journal, 168(6), 739.

International Snowmobile Manufacturers Association (2014). Snow facts. Retrieved November 20, 2014 from http://www.snowmobile.org/pr_snowfacts.asp

Joling, D. (2001). Deaths by snowmachine pile up in Alaska. The Peninsula Clarion. Retrieved November 20, 2014 from http://peninsulaclarion.com/stories/021101/ala_021101ala0080001.shtml

Landen, M. G., Middaugh, J., & Dannenberg, A. L. (1999). Injuries associated with snowmobile injuries, Alaska, 1993-1994. Public Health Reports, 114(1):48-52.

McGhan, P. (2014). Lurking dangers. Alaska SnowRider. Retrieved November 20, 2014 from www.RideAlaska.com

Medred, C. (2010). Another fatal snowmachine accident, 7 this season. Alaska Dispatch News. Retrieved November 20, 2014 from http://www.adn.com

Pierz, J. (2003). Snowmobile injuries in North America. Clinical Orthopaedics and Related Research, 409, 22-36

Snyder, C., Muensterer, O., Sacco, F., & Safford, S. (2014). Paediatric trauma on the Last Frontier: An 11-year review of injury mechanisms, high-risk injury patterns and outcomes in Alaskan children. International Journal of Circumpolar health, 73(25066), 1-7.

Sullivan, J. (2014). White-out wipeout. Alaska SnowRider. Retrieved November 20, 2014 from www.RideAlaska.com

Sy, M.L., & Corden, T. E. (2000). The perils of snowmobiling. Wisconsin Medical Journal, 104(2), 32-34.

Wright, K. (2014). Practicing what they preach. Alaska SnowRider. Retrieved November 20, 2014 from www.RideAlaska.com

Wyrick, D., & Maxson, R. T. (2014). Patterns of Injuries in newer mechanisms of pediatric injuries (ATVs, snowmobiles, trampolines, flat screen TVs). Current Surgery Reports, 2:61, 1-7.

snowmachine (continued from page 13)

PRN Negotiations Underway by Donna Phillips, BSN, RN

Providence Registered Nurses (PRN) met with representatives of Providence Alaska Medical Center March 17th to begin work on a successor Collective Bargaining Agreement. The current Collective Bargaining Agreement (CBA) expires April 30 of this year. The PRN team is comprised of four seasoned negotiators and two faces new to the bargaining table, but not new to Providence. The seventh team member and spokesperson for the nurses is Mike Tedesco, Adjunct Professor at the University of Oregon School of Law and with the University of Oregon Master’s Degree Program in Conflict and Dispute Resolution.

Bargaining priorities for the nurses’ team were developed from the recent survey distributed among PRN members. The bargaining survey team worked to develop the survey that was distributed on site at PAMC on five different days for six to 14 hours each day. If the nurses were not able to make one of these onsite meetings, they were able to fill out the survey on line.

The negotiating team, Terra Colegrove (President-PRN), Jane Erickson (VP-PRN), Joe Peacott (PRN-Grievance Officer), Julie Eib (PRN-Grievance Officer), Robin Savage (NICU-RN) and Donna Phillips, (PRN-Treasurer) were joined by strategy team members, Danielle Heyl (ACC-fellowship) and Lorayne Embretson (PRN-Secretary) to finalize proposals to present at the 2015 negotiations with PAMC. We are confident that our proposals reflect what the nurses would like to see in their new contract.

As we have witnessed the changes within the Providence Health System since our last negotiations, it is imperative that our members show solidarity for our union. Please look for updates in your email and on the Providence Registered Nurses Facebook page.

THE ALASKA NURSE • ApR iL/MAy 2015The off ic ial Publ icaT ion of The alaska nurses associaT ion14 15

www.aknurse.org

aanaboardofdirectorsMeeting4thWednesdayeachmonth 4:30 to 6:00 pm

aanalaborcouncilMeeting4thWednesdayeachmonth 6:00 to 7:30 pm

• aanaProfessionalPracticecommittee

• aanahealthandsafetycommittee• aanaeditorialcommittee• aanacontinuingeducationcommittee

• aanaspecialeventscommittee• aanalegislativecommittee

contactandrea@aknurse.orgfortimes

Providence registered Nurses 3rdthursdayofeachmonth 4:00 to 6:00 pm

rn’sunitedofcentralPeninsulahospitalcontactfortimes:907-252-5276

ktnketchikanGeneralhospitalcontactfortimes: 907-247-3828

Alaska state Board of Nursing MeetingUpcoming Meetings:

July8-10,2015 - Anchorage agenda deadline June 17, 2015

october21-23,2015 - Fairbanks agenda deadline September 30, 2015

The Alaska Board of Nursing has a listserv that is used to send out the latest information about upcoming meetings, agenda items, regulations being considered, and other topics of interest to nurses, employers, and the public. To sign up for this free service, visit www.nursing.alaska.govInquiries regarding meetings and appearing on the agenda can be directed to:

Nancy Sanders, PhD RN, Executive Administrator, Alaska State Board of Nursing

550 West 7th Ave, Ste 1500, Anchorage, AK 99501 • Ph: 907-269-8160 • Fax: 907-269-8156 Email: nancy.sanders@alaska.gov

freeWebinarofferingfromaana!You are invited to a free continuing nursing education webinar provided by the Alaska Nurses Association: child’sPlay…orNot? A webinar introducing an evidence-based practice tool for identifying child maltreatment. available24/7,online. Earn 2.0 contact hours. aknurse.telspanexam.com

Mothers,infantsandfamilieswithsubstancedependence:advancesand challenges conferenceapril15-16,2015, Anchorage www.aknurse.org/index.cfm/education

Alaska school Nurses Association Annual conference“Positioning Ourselves as Professionals” april24-26,2015 www.alaskasna.org/conferences.html

2015alaskaheartrunapril25,2015• Join Team AaNA and stop by our booth! www.aknurse.org

freece:childMaltreatmentrecognition&reportingapril29,2015• 5:30 pm Register online at www.aknurse.org

nationalnursesWeek2015May6-12 • Happy Nurses Week from the Alaska Nurses Association

2015nursesWeekbanquetMay9,2015 Tickets available online! www.aknurse.org

specialscreeningoftheamericannurse!JoinaanaatthebeartoothMay11,2015 Tickets available online! www.aknurse.org

2015asthma&allergyconferenceseptember11-12,2015 conference.aafaalaska.com

remembertovisit:www.aknurse.org/index.cfm/education for frequent updates and information on local nursing contact hour opportunities and conferences!

Calendar of EventsSave the Dates!

by Andrea Nutty

On Sunday, March 8th, UAA student nurses joined nurse members and staff from the Alaska Nurses Association at the Sullivan Arena in Anchorage to participate in the 2015 Alaska Kidney Walk. Nursing students provided blood pressure checks and helped participants understand whether their levels fell into a healthy, cautionary, or unhealthy category. This year was AaNA’s first time participating in the walk; and Team Alaska Nurses saw seven participants in the Kidney Walk.

The Alaska Kidney Walk serves as a fundraiser for the Alaska Kidney Patients Association, a statewide non-profit organization dedicated to support, education, and advocacy for kidney patients and their families; public education; increasing organ donation; and the prevention of kidney disease in Alaska. The 2015 Kidney Walk raised nearly $14,000 to support the programs and services of the Alaska Kidney Patients Association. All funds raised stay in our state.

A majority of the participants at the Kidney Walk were kidney patients and their family and friends who were walking to support them. Many walking had either received or donated a kidney. Many participants faced hereditary diseases or diabetes, and many others were undergoing dialysis. Currently, over 150 Alaskans are on the waiting list for a kidney transplant. Thousands more are impacted by chronic kidney disease, with the rate of end stage renal failure doubling over the past decade.

For more information on the Alaska Kidney Patients Association, visit www.alaskakidney.org. Consider joining Team Alaska Nurses for the 2016 Kidney Walk!

Nurses Volunteer, Raising Funds & Awareness in 2015 Kidney Walk

The off ic ial Publ icaT ion of The alaska nurses associaT ion16

EMPLOYMENT OPPORTUNITIES

people first

for complete listings and to apply

BANNERHEALTH.COM/CAREERS

14-FMH-1090- HR Recruitment Print Ad-1b_bc.indd 1 1/30/14 11:34 AM

EMPLOYMENT OPPORTUNITIES

people first

for complete listings and to apply

BANNERHEALTH.COM/CAREERS

14-FMH-1090- HR Recruitment Print Ad-1b_bc.indd 1 1/30/14 11:34 AM

MINI HARDTOP 4 DOOR MINI COUNTRYMAN MINI HARDTOP 2 DOOR

MINI OF ANCHORAGE800 East 5th AvenueAnchorage, AK 99501

*All-wheel drive available on MINI Cooper S Countryman ALL4. ^Dealer required to verify eligibility of USAA Members. © 2015 MINI USA, a division of BMW of North America, LLC. The MINI name, model names and logo are registered trademarks.

(855) 407-1983MINIANCHORAGE.COM

Eligible USAA members can now get an additional incentive of up to $1,000* on select models.

With a new MINI, today could be the first day of the rest of your Motoring life. Whether it’s the legendary go-kart handling of the original Hardtop 2 Door, the additional doors for easy family access of the Hardtop 4 Door, or the seating for five and available all-wheel drive of the Countryman, whatever your Motoring lifestyle, MINI has a model that’s right for you.

THERE IS SUCH A THING AS THE PERFECT FAMILY.