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THE OFFICIAL PUBLICATION OF THE KENTUCKY NURSES ASSOCIATION
Volume 63 • No. 3
Quarterly publication direct mailed to approximately 79,000 Registered Nurses & LPNs in Kentucky
July, August, September 2015
KNA Election 2015
Cultural Diversity
Biographical Information
Page 10
Costa Rica Mission Trip
Page 14
President’s Pen
The Nurse Researcher and Scientist
Teresa H. Huber, DNP, MSN, RN
Happy Summer and Happy Independence Day!
Nursing research has always been a part of
nursing, but serious efforts to include research
to guide practice only began about 50 years ago.
Before this, nursing science involved long-standing
traditions, personal beliefs, and protocols borrowed
from other disciplines. Nurses today understand that
utilizing research findings is a critical component of
professional practice.
Traditionally, nurses have not been considered
researchers. The public perception of the nurse is
often affected by individual experiences with nurses.
Nurses as well as patients tend to value clinical
practice over nursing scholarship and research.
According to the American Nurses Association
(2010), nurses integrate research into professional
practice by the following:
1.
Utilizing
current
evidence-based
nursing
knowledge, including research findings, to
guide practice.
2.Incorporating evidence when initiating changes
in nursing practice.
3.Participating, as appropriate to education level
and position, in the formulation of evidencebased practice (EBP) through research.
4.
Sharing personal or third-party research
findings with colleagues and peers.
The research process in nursing enables the
professional nurse to understand basic research
principles, analyze study results, and use research
findings to guide patient care. The process begins
with a rigorous series of logical steps of inquiry
about some aspect of nursing that has arisen that
seems interesting or an idea stimulated from clinical
practice.
Why do research? Research is a systematic
process to incorporate study findings into clinical
practice. An example of an application is a nurse
administering medications. To stay current with
practice changes, professional nurses must read
the current literature and apply the findings as
appropriate.
Evidence-based practice (EBP) has
become a standard of care delivery. While EBP does
not rely solely on research findings, but may include
experience, quality improvement, and other items,
nursing research does provide the nurse with the
opportunity to supply their own body of evidence for
clinical practice.
Many health care organizations encourage nurses
to implement EBP projects and display commitment
in providing health care team members with the
required time and resources. Advanced technology
lends support for the nurse researcher today,
with greater data storage and analysis. Computer
programs can manipulate numbers to disseminate
findings much more rapidly.
Careers in nursing research begin often as a
research assistant, data coordinator, or clinical
research monitor. The principle investigator reflects
the most senior research role, and has the greatest
responsibility and accountability associated with
the study. Nurse researchers are discovering ways to
improve healthcare delivery services to chronically
ill patients, educate patients to make better lifestyle
choices, improve patient safety issues and prevention
of illness and injury as well as to address end of life
Presort Standard
US Postage
PAID
current resident or
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issues. Nurse researchers
may partner with other
scientists, in areas such
as medicine, pharmacy, or
engineering to address current issues.
Over the past few decades, nurses have made
great progress in implementing the use of scientific
evidence in clinical practice. Sigma Theta Tau
International sponsored the first international
research utilization conference in 1998. As more
nurses assume the role of researcher and scientist,
the public will acknowledge this side of nursing.
These nurses will determine how to incorporate the
best possible evidence to guide and change clinical
practice in today’s complex healthcare environment.
Please mark your calendar and plan to attend the
KNA Education Summit on Friday, October 2, at the
Embassy Suites in Lexington, Ky. We hope to see you
there!
American Nurses Association. (2010). Nursing scope and
standards of practice (2nd ed.). Silver Spring, MD:
Author.
Hood, L.J. (2014). Leddy & Pepper’s conceptual bases
of professional nursing (8th ed.). Philadelphia, PA:
Lippincott Williams & Wilkins.
National Institute of Nursing Research. (2011). Mission and
strategic plan. Retrieved from https://www.ninr.nih.
gov/sites/w w w.ninr.nih.gov/files/ninr-strategic-plan2011.pdf
Nursing World. (2015). Research Tool Kit. Retrieved from:
http://www.nursingworld.org/EspeciallyForYou/NurseResearchers
Sigma Theta Tau International. (2015). Honor society of
nursing. Retrieved from: http://www.nursingsociety.org/
aboutus/Pages/AboutUs.aspx
Index
President’s Pen .. . . . . . . . . . . . . . . . . . . . . 1
Chapter News. . . . . . . . . . . . . . . . . . . . . . . 16
Accent on Research . . . . . . . . . . . . . . . . . . 3
Member Get a Member. . . . . . . . . . . . . . . . 17
Letter to the Editor. . . . . . . . . . . . . . . . . . . 3
Nurses On The Move . . . . . . . . . . . . . . . . . 17
Student Spotlight. . . . . . . . . . . . . . . . . . . 4-9
Poetry Corner. . . . . . . . . . . . . . . . . . . . . . . 18
KNA 2015 Election. . . . . . . . . . . . . . . . . . . 10
KNA Calendar of Events 2015. . . . . . . . . . . 19
Cultural Diversity. . . . . . . . . . . . . . . . . . . . 14
Membership Application. . . . . . . . . . . . . . . 19
Page 2 • Kentucky Nurse
July, August, September 2015
Chapters Presidents and Treasurers - 2015
PRESIDENTS
TREASURERS
RIVER CITY CHAPTER (Formerly District 1)
Carolyn Claxton, RN
H: 502-749-7455
Paulette F. Adams, EdD, RN
1421 Goddard Avenue
3047 Crystal Waters Way
Louisville, KY 40204-1543
Louisville, KY 40299-4897
E-Mail: [email protected]:Mail: [email protected]
BLUEGRASS CHAPTER (Formerly Chapter 2)
Amy E. Herrington, DNP, RN, CEN H: 859-619-2082
112 Lakeview Court
Georgetown, KY 40324
E-Mail: [email protected]
Nancy Garth, RN
3292 Shoals Lake Drive
Lexington, KY 40515
E-Mail: [email protected]
NORTHERN KENTUCKY CHAPTER (FORMERLY DISTRICT 3)
Deborah J. Faust, MSN, RN
H: 859-655-1961
Debbie Cummings, MSN, RN, BC
2041 Strawflower Court
125 Kincaid Lane
Independence, KY 41051
Erlanger, KY 41018
E-Mail: [email protected]
E-Mail: [email protected]
HEARTLAND CHAPTER (FORMERLY DISTRICT 4)
Kathleen M. Ferriell, MSN, BSN, RN H: 502-348-8253
Susan E. Nesmith, APRN, RN
125 Maywood Avenue
W: 270-692-5146
1623 Hutcherson Lane
Bardstown, KY 40004
Elizabethtown, KY 42701-8977
E-Mail: [email protected]: [email protected]
H: 502-267-4372
C: 859-312-0599
H: 859-271-9529
W: 859-323-0733
H: 859-360-6814
H: 270-300-4062
W: 270-706-1683
WEST KENTUCKY CHAPTER (FORMERLY DISTRICT 5)
Nancy Armstrong, MSN, RN
H: 270-435-4466
Katy Garth, PhD, RN
H: 270-435-4544
1881 Furches Trail
W: 270-809-4576
358 Butterworth Road
W: 270-762-6669
Murray, KY 42071
Murray, KY 42071
E-Mail: [email protected]: [email protected]
KENTUCKY NURSES REACH – RESEARCH, EDUCATE,
ADVOCARE, CARE, HELP (FORMERLY DISTRICT 7)
Kim Bourne, MSN, RN, CNE
H: 270-427-5554
147 Bulldog Road
Glasgow, KY 42141
E-Mail: [email protected]
Ann Afton, MSN, RN, APRN
1813 Boyce Fairway Road
Alvaton, KY 42122-7606
E-Mail: [email protected]
GREEN RIVER CHAPTER (FORMERLY DISTRICT 8)
Kim Bullock, RN, BSN
Carol Murch, APRN, MSN 693 Porter School House Road
18143 Upper Delaware Road
Calhoun, KY 42327
Henderson, KY 42420
E-Mail: [email protected]: [email protected]
NIGHTINGALE CHAPTER (FORMERLY DISTRICT 9)
JoAnn Wever, MSN, RN
H: 859-336-5938
Charlene Maddox, BSN, RN
300 Covington Avenue
4330 Lebanon Road
Springfield, KY 40069
Danville, KY 40422
E-Mail: [email protected]
E-Mail: [email protected]
NORTHEASTERN CHAPTER
Michelle L. Rayburn, MSN, RN
W: 606-783-7793
St. Claire Regional Medical Center
222 Medical Center
Morehead, KY 40351
E-Mail: [email protected]
O: 270-745-4574
C: 270-791-3675
H: 270-521-9980
W: 270-831-9787
H: 859-236-6936
Information for Authors
• Kentucky Nurse Editorial Board welcomes submission articles to be
reviewed and considered for publication in Kentucky Nurse.
• Articles may be submitted in one of three categories:
• Personal opinion/experience, anecdotal (Editorial Review)
• Research/scholarship/clinical/professional issue (Classic Peer Review)
• Research Review (Editorial Review)
• All articles, except research abstracts, must be accompanied by a signed Kentucky Nurse transfer of copyright
form (available from KNA office or on website www.Kentucky-Nurses.org) when submitted for review.
• Articles will be reviewed only if accompanied by the signed transfer of copyright form and will be considered for
publication on condi­t ion that they are submitted solely to the Kentucky Nurse.
• Articles should be typewritten with double spacing on one side of 8 1/2 x 11 inch white paper and submitted in
triplicate. Maximum length is five (5) typewritten pages.
• Articles should also be submitted electronically
• Articles should include a cover page with the author’s name(s), title(s), affiliation(s), and complete address.
• Style must conform to the Publication Manual of the APA, 6th edi­t ion.
• Monetary payment is not provided for articles.
• Receipt of articles will be acknowledged by email to the author(s). Following review, the author(s) will be notified of
acceptance or re­jection.
• The Kentucky Nurse editors reserve the right to make final editorial changes to meet publication deadlines.
• Articles should be mailed, faxed or emailed to:
Editor, Kentucky Nurse, Kentucky Nurses Association, P.O. Box 2616, Louisville, KY 40201-2616
(502) 637-2546 • Fax (502) 637-8236 • or email: [email protected]
“The purpose of the Kentucky Nurse shall be to convey information
relevant to KNA members and the profession of nursing and practice of
nursing in Kentucky.”
Copyright #TX1-333-346
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]. KNA 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 Kentucky 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. KNA 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 KNA or those of the national or local
associations.
The Kentucky Nurse is published quarterly every January, April,
July and October by Arthur L. Davis Publishing Agency, Inc. for Kentucky
Nurses Association, P.O. Box 2616, Louisville, KY 40201, a constituent
member of the American Nurses Association. Subscriptions available
at $18.00 per year. The KNA organization subscription rate will be $6.00
per year except for one free issue to be received at the KNA Annual
Convention. Members of KNA receive the newsletter as part of their
membership services. Any material appearing herein may be reprinted
with permission of KNA. (For advertising information call 1-800-6264081, [email protected].) 16mm microfilm, 35mm microfilm, 105mm
microfiche and article copies are available through University Microfilms
International, 300 North Zeeb Road, Ann Arbor, Michigan 48106.
2015 EDITORIAL BOARD
EDITORS
Ida Slusher, PhD, RN, CNE (2013-2016)
Maureen Keenan, JD, MAT
MEMBERS
Trish Birchfield, PhD, RN, APRN (2012-2015)
Donna S. Blackburn, PhD, RN (2011-2014)
Patricia Calico, PhD, RN (2012-2015)
Sherill Cronin, PhD, RN, BC (2011-2014)
Joyce E. Vaughn, BSN, RN, CCM (2013-2016)
REVIEWERS
Dawn Garrett-Wright, PhD, RN
Elizabeth “Beth” Johnson, PhD, RN
Connie Lamb, PhD, RN, CNE
Joyce E. Vaughn, BSN, RN, CCM
Deborah A. Williams, EdD, RN
KNA BOARD OF DIRECTORS
PRESIDENT
Teresa H. Huber, DNP, MSN, RN (2013–2016)
IMMEDIATE PAST-PRESIDENT
Kathy L. Hall, MSN, BSN, RN (2014-2015)
VICE-PRESIDENT
Michael Wayne Rager, DNP, PhD(c), FNP-BC, APRN, CNE (2013-2015)
SECRETARY
Beverly D. Rowland, PhD(c), RN, CNE (2013-2015)
TREASURER
Joe B. Middleton, MSN, APRN, CEN, CC/NRP (2014-2016)
DIRECTORS-AT-LARGE
Teena L. Darnell, MSN, BSN, RN (2013–2015)
Peggy T. Tudor, MSN, RN, EdD (2013-2015)
JoAnn M. Wever, MSN, RN (2014 – 2016)
Kathy Hager, DNP, ARNP, CFNP, CDE (2014-2016)
EDUCATION & RESEARCH CABINET
Liz Sturgeon, PhD, RN, CNE (2014-2016)
GOVERNMENTAL AFFAIRS CABINET
Alicia Marquess, MSN, BSN, RN (2014-2016)
PROFESSIONAL NURSING PRACTICE & ADVOCACY CABINET
Sheila Washburn, RN
KNF PRESIDENT
Mary A. Romelfanger, MSN, RN, CS, LNHA
KANS Consultant
Tracy S. Patil, EdS, MSN, RN
KNA STAFF
EXECUTIVE DIRECTOR
Maureen Keenan, JD, MAT
www.kentucky-nurses.org
Published by:
Arthur L. Davis
Publishing Agency, Inc.
July, August, September 2015
Kentucky Nurse • Page 3
Accent on Research
DATA BITS
Are Individuals With Heart Failure Being
Set Up for Failure at Discharge?
Terrie R. Gibson, RN, BSN student at Lansing
School of Nursing and Health Sciences,
Bellarmine University, Louisville, KY
Heart failure (HF) is a chronic condition that
is associated with a high incidence of mortality,
morbidity, and economic burden. Individuals with
HF may experience multiple hospitalizations and
readmissions shortly after discharge. Many of
these readmissions could be decreased with proper
education and ensuring individuals meet certain
discharge criteria. A recent nursing research study
explored the clinical and diagnostic characteristics
of individuals with a primary diagnosis of HF at the
time of discharge and compared the relationship of
these indicators in individuals who did and did not
experience a HF readmission within 60 days of their
previous hospitalization.
This HF readmission study took place at a large
hospital system in the mid-Atlantic region of the
United States. The clinical factors for this study
were derived from the recommendations of the Heart
Failure Society of America (HFSA) for treatment
goals and discharge criteria. The data for the study
were retrieved from a retrospective review of all
individuals discharged with the primary diagnosis of
HF at the two study institutions for two consecutive
years, using data from January-August 2009. To
be included in the study, the individual had to be
admitted for greater than 24 hours, discharged
with a primary diagnosis of HF, be older than 50
years old, have no other cardiac events in the past
30 days, could not have died within 60 days of
hospitalization, and could not have been discharged
to a hospice setting after initial hospitalization.
Demographic data, clinical information, and patient
histories were taken from the medical records. Of
the 134 individuals studied, 65 (48.5%) were in the
readmission group and 69 (51.5%) were in the no
readmission group. The study included more women
(55.2%) than men (44.8%), with an average age of
75.25 years. Many of the individuals in the study
experienced comorbidities that are often associated
with HF. The most common comorbidities were
hypertension (79.1%), cardiac arrhythmias (57.5%),
coronary artery disease (55.2%), and diabetes
mellitus (51.5%).
Logistic regression analysis was used to predict
the probability of an individual being readmitted
for HF within 60 days, using the key study factors.
This model indicated that the three most predictive
variables for readmission were assistance with
ADLs, presence of crackles, and presence of
dyspnea. According to the model, individuals who
required assistance with ADLs were 10 times
more likely to experience readmission within 60
days. As well, individuals with crackles during
the 24-hours prior to discharge were 5 times more
likely of readmission within 60 days and individuals
with dyspnea during the 24-hour period prior to
discharge were 2 times more likely to be readmitted
within 60 days for HF.
The researcher concluded that the clinical
characteristics and symptoms at the end of
hospitalization in individuals with HF are highly
suggestive of whether or not the individual will be
readmitted within 60 days for HF. The evaluation
of symptoms, including crackles and dyspnea, at
the time of discharge, is extremely important for
determining if an individual with HF is ready to be
discharged. Symptoms cause individuals to seek
medical attention, and that in turn, often results
in hospitalization and readmissions. Discharge
instructions should include patient education
regarding symptom awareness and management,
ability to perform ADLs, and evaluation of home care
needs, including social services, and physical and
occupational therapy.
Source:
Anderson, K. M. (2014). Discharge clinical characteristics
and 60-day readmission in patients hospitalized with
heart failure. Journal of Cardiovascular Nursing, 29(3),
232-241.
Data Bits is a regular feature of Kentucky Nurse.
Sherill Nones Cronin, PhD, RN-BC is the editor of the
Accent on Research column and welcomes manuscripts
for publication consideration. Manuscripts for this column
may be submitted directly to her at: Bellarmine University,
2001 Newburg Rd., Louisville, KY 40205.
Letter to
the Editor
Ms, R Carlene Gottbrath
Administrative Coordinator
Kentucky Nurses Association
P.O. Box 2616
Louisville, KY 40201-2616
Dear Ms. Gottbrath
I recently sent you an email regarding an incident
where one of your nurses came to the aid of my wife.
You suggested that I send you a letter so that you
might place it in your monthly news letter.
My wife and I were on a wonderful Alaskan cruise
in July 2014 to celebrate my wife’s retirement. On
the last day of our cruise in the port of Victoria
British Columbia my wife slipped and fell on the
deck while coming out of the ladies restroom near
the pool. I was not present as I was inside waiting
to pick up food for us. A passenger heard my wife’s
screams and came to her aid. My wife was in intense
pain and was in shock from the fall. I immediately
came out on deck after someone called my name.
A lady was assisting my wife and told me she was
a nurse from Kentucky. The lady was wonderful in
calming my wife and not letting anyone touch her.
My wife fractured her humerus in four places and
had other injuries. After months of physical therapy
my wife is doing better. In all of the mayhem of
getting her up and into a wheel chair and to medical
treatment I didn’t have time to get the wonderful
nurses name. I just want to give a big thank you
to her and the Kentucky Nurses Association for
training nurses to react to emergency situations,
even while on their vacation.
Sincerely,
Gary Coulliette
[email protected]
Peter Naake
Buddy Cutler
Direct line: (502) 632-5288
Direct line: (502) 632-5270
[email protected]
[email protected]
Representing Injured Nurses
Representing fired nurses and
those charged at the KY BON
Republic Building, 8th Floor
429 W. Muhammad Ali Blvd
Louisville, KY 40202
www.pcmmlaw.com
www.PeterNaakeLaw.com
This is an advertisement.
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Page 4 • Kentucky Nurse
July, August, September 2015
Student Spotlight
Childhood Overweight and Obesity
Dr. Martha D. Hawkins DNP, APRN, CPNP
Indiana Wesleyan University
Sharon Edwards DNP, APRN, PMHNP-BC
Eastern Kentucky University
According to the Centers for Disease Control and
Prevention (CDC), recent statistics indicate that 17%
of children between the ages of two years and 19
years are obese (CDC, n.d.). Childhood obesity has
become one of the newest chronic illnesses. A child
who enters adolescence obese has an 80% chance
of remaining obese into adulthood (Robinson,
Geier, Rizzolo, & Sedrak, 2011). Complicating the
overall rising childhood obesity rates is increasing
healthcare disparities. The most at-risk children
include
Native-American,
African-American,
Hispanic and low-income children. Kentucky has
one of the highest rates of childhood obesity (CDC,
n.d.). In this article childhood obesity in Kentucky
will be discussed and a validation of data from
a primary care clinic‘s pediatric charts will be
presented.
Childhood Obesity in Kentucky
While efforts to combat the obesity epidemic
in Kentucky have born some fruit for the adult
population with Kentucky moving from third in
2000 (Singh, Kogan & van Dyck, 2008) to seventh
in 2010 (Robert Wood Johnson, 2010), the obesity
rate remains a staggering 30.5% (Robert Wood
Johnson Foundation (RWF), 2010). Unfortunately,
such improvements are not seen in childhood obesity
rates with Kentucky ranking third in the nation
since 2000 (Singh, Kogan, & van Dyck, 2008).
Data from the Robert Wood Johnson Foundation
(2012) identified that in spite of marked legislative
efforts to combat obesity the epidemic continues.
Unfortunately, more than 20% of Kentucky’s
children are currently identified as obese (Kaprowy,
2012).
In 2011, Kentucky’s population estimate was
4,369,356 people (United States Census Bureau).
Of this population, 23.4% were children under
18-years of age (United States Census Bureau, 2012).
This translates to an estimated 1,022,429 children
living in Kentucky in 2011, of whom, conservatively,
204,492 children are obese. Regretfully, the overall
obesity rate in Kentucky is predicted to exceed
60% by 2030 (Truman, 2012). In Kentucky, obesity
is predicted to cause almost 600,000 new cases
of diabetes, 1.2 million new cases of coronary
heart disease, almost 1.2 million new cases of
hypeliension, almost 750,000 new cases of arthritis
and almost 200,000 new cases of obesity-related
cancer over the next twenty years (Truman, 2012).
The predicted costs of care could climb as much as
17.6%, making it the 17th highest increase in cost in
the country (Truman, 2012).
Complications of obesity are occurring in children
and contribute to the devastating health and
financial costs for Kentucky. Addressing the physical
complication of obesity, Robinson, Geier, Rizzolo,
and Sedrak (2011) reported that “...80% of 10 to 15
year olds who are overweight become obese adults by
age of 25 years...Physical complications can involve
the cardiovascular, endocrine, gastrointestinal,
musculoskeletal, nervous, and respiratory systems”
(p. 59). Specific complications of obesity include
such things as hypertension, type 2 diabetes,
dyslipidemia, orthopedic complications, asthma,
and obstructive sleep apnea (Robinson et al., 2011).
Obesity is associated with more that thirty known
disease processes (August et al., 2007; Gunturu &
Ten, 2007).
The psychological impact of obesity includes low
self-esteem, increased rates of sadness, loneliness,
and anxiety (Robinson et al., 2011). In addition to
the psychological challenges, many overweight and
obese children are teased and ostracized. Children
with weight difficulties are more likely to drink,
smoke, and experience an eating disorder, further
challenging their health status (CDC, n.d.).
Resources for treating childhood obesity in
Kentucky are very limited. In 2008, providers within
the target clinic system in Kentucky identified the
need for resources for their overweight and obese
pediatric patients but were unable to access services
(A. Giles, Personal Communication, March 10,
2008). More than 90% of all clients receiving care
within the target system had Medicaid, Medicare or
KCHIP as their payer source, further limiting choices
(A. Giles, Personal Communication, March 10, 2008).
Review of Pediatric Charts Results
A retrospective chart review was conducted to
determine the rate of overweight and obese children.
For the purpose of the chart review, overweight was
defined as at or between the 85-94 percentiles and
obese was defined as at or above the 95th percentile
for age and gender for national standards on the
CDC growth charts (Barlow, 2007). An additional
indictor used to define obesity was ideal body
weight with obesity being defined as greater than or
equal to 120% ideal body weight (Pediatric Practice
Research Group, 2008).
The retrospective chart review was conducted to
determine three characteristics among two of the
system’s pediatric population groups (ages 4-6 years
and 11-13 years). The three characteristics were: 1.)
A baseline of overweight and obesity rates among
children, 2.) The baseline rate of comorbid conditions
in children currently overweight or obese, and, 3.)
A comparison of the rates of healthcare resource
utilization for illness between underweight/normal
weight children and overweight/obese children.
Healthcare resource utilization was evaluated
by counting the number of illness visits per each
child over an 18-month time period. All preventive
health visits were excluded from the count. A
convenience sample of charts was selected for review
that included both identified groups who received
physical examinations from May 1, 2012 through
July 31, 2012. The sample consisted of 332 charts
for review, 176 charts for the 4-6 year old group and
156 charts for the 11-13 year old group.
Overweight and obesity rates were calculated by
simple percentage among groups and for the total
selected charts. Comparison of healthcare resources
between the underweight/normal weight group and
the overweight/obese group were conducted by onetailed t-test.
The results revealed a high rate of overweight and
obese children in the healthcare system, with 31.9%
of all children identified as obese; 19.9% of 4-6 year
olds and 45.5% of 11-13 year olds. Additionally,
another 14.2% of children were identified as
overweight consisting of 17% of 4-6 year olds and
10.9% of 11-13 year olds. Combined, 46.1% of all
children were either overweight or obese which is
well above the national average of 37% (Henry J.
Kaiser Foundation, 2009)
Comorbid conditions considered in the chart
review included asthma and allergies as indicators
of airway obstruction, history of adenoidectomy,
snoring, sleep disordered breathing, constipation,
gastroesophageal reflux disease, enuresis, indicators
of abnormal glucose metabolism such as polyuria,
polyphagia, and polydipsia, polycystic ovarian
syndrome, dysmenorrhea, behavioral problems,
dyslipidemia, skin abnormalities such as eczema,
lesions with changes, acne, Acanthosis Nigricans,
and xerosis, and orthopedic problems such as flat
feet and joint pain (August et aI., 2007; Gunturu &
Ten, 2007). The rate of comorbidity for all overweight
and obese children when considered together as
a group was 69.5%. This rate remained stable
across age groups with 68% of 4-6 year olds and
66.9% of 11-13 year olds already demonstrating
comorbid conditions. An interesting finding noted
that comorbid conditions were found in 60% of
overweight 4-6 year olds and 50% of overweight 1113 year olds. Interestingly, the obese 4-6 year olds
had a higher rate of comorbid conditions than the
obese 11-13 year olds. These data suggest that issues
associated with excess weight are demonstrated
before children reach the standard definition of
obesity for half of the children in the sample.
The use of illness care resources among
underweight/normal weight children was compared
to that of overweight/obese children. Illness care
visits were counted for an 18-month period in 2011
and 2012 for each child in the sample, with the
exclusion of all wellness visits. A one-tailed t-test
was conducted to determine if the overweight/
True health is more than having the
skills, advanced training and the latest
technology, although we certainly do.
It’s about giving - the heart, the time, a
listening ear - to be fully here for those
who need us. That’s who we are at
Baptist Health Corbin. That’s why we’re
here.
To find out more about Baptist Health
Corbin or job opportunities, visit our
website at BaptistHealthCorbin.com.
Job Line: 877-562-2762
Visit www.HomeHealthQuality.org/KY
An Equal Opportunity Employer
July, August, September 2015
Kentucky Nurse • Page 5
Student Spotlight
obese group of children had a greater expenditure of
healthcare resources than the underweight/normal
weight group of children. The mean number of days
of illness care in the underweight/normal weight
group was 2 days per child in the 18-month period.
The mean number of days of illness care for the
overweight/obese group was 2.3 days per child (t (5)
=0.09, <0.05). Even though this was not statistically
significant, 0.3 days per child amounts to 46 days
of office visits in 18 months. At standard Medicaid
reimbursement rates, this amounts to over $1450.00
in illness care in one practice directly associated
with childhood comorbidities of overweight and
obesity. This sum only represents the short-term
costs to Kentucky and our nation as a result of this
rapidly spreading new childhood epidemic.
Discussion
When reviewing the staggering numbers of
overweight and obesity in very young children in
this survey, two major implications stand out. First,
overweight preschoolers and kindergartners may
already have comorbid conditions. The comorbid
conditions most often affected their breathing and
include asthma, sleep disordered breathing and
tonsilar hypertrophy. Second, by the time these
overweight 4-6 year olds make it to adolescence,
they are no longer overweight; they are obese at
staggering rates. With the knowledge that a child
who enters adolescence obese has an eighty percent
chance of remaining obese for life (Robinson, et.
AI., 2011), there is a strong implication that a very
fragile, short window exists during which we can
successfully intervene for overweight and obese
children. The findings of this study also indicated
that it may be too late to wait until a child is already
obese to start intervening, meaning that healthcare
providers must reset our perceptions of what a
“normal” child looks like to reflect a valid reality.
The implications of childhood obesity for the
United States are staggering. Kentucky stands to
bear a higher burden than most states because
of our consistently high rate of childhood obesity
and our failure to make progress towards healthier
weights in children. The burden of adult chronic
disease in childhood and adolescence means that
our healthcare costs, morbidity and mortality will
go up as a state and our productivity will go down
as this problem increases. Additionally, education
of pediatric providers will have to change to care for
these problems. These are areas in which advanced
practice nurses can lead the way with novel
approaches to care; but, new care models will not be
without challenges of their own as we move into the
world of healthcare reform.
The incidence of pediatric overweight and obesity
in Kentucky presents a significant concern for the
well-being of children now and in the future. The
presence of overweight and obese children will cost
individuals, families, and the Commonwealth of
Kentucky a significant financial cost from loss of
productivity and decreased overall health status.
The need for a comprehensive program to support
these children and their families is evident and must
be implemented to prevent the potential reduction
of health status, productivity and cost to the
healthcare system of Kentucky.
References
August, G., Caprio, S., Fennoy, I., Freemark, M., Kaufman,
F., Lustig, R , Silverstein, J.,Speiser, P., Styne, D.,
& Montori, V. (2008). Prevention and treatment of
pediatric obesity: An Endocrine Society clinical practice
guideline based on expert opinion. Journal of Clinical
Endocrinology and Metabolism, 93: 4576-4599. DOl:
http://dx.doi.org/10.1210/jc.2007-2458
Barlow, S & the Expert Committee of the American
Academy of Pediatrics. (2007). Expert Committee
recommendations regarding the prevention, assessment
and treatment of child and adolescent overweight and
obesity: Summary report. Pediatrics, 120:s164-s192.
DOl: 10.1542/peds.2007-2329C.
Centers for Disease Control, & Prevention. (n.d.).
Overweight and obesity: Data and statistics. Retrieved
from: http://www.cdc.gov/obesity/datalindex.html
Gunturu, S., & Ten, S. (2007). Complications of obesity in
childhood. Pediatric Annals, 36(2), 96-99.
Henry J. Kaiser Foundation. (2009, July 9). In Henry J.
Kaiser Foundation (Ed.), StateHealthFacts. Retrieved
from: w w w.statehealthfacts.orglcomparemaptable.
jsp?ind=51&cat=2
Kaiser Commission on Medicaid, & the Uninsured.
(2012, July). Where are States today? Medicaid and
CHIP eligibility levels for children and non-disabled
adults. Retrieved from http://www.kfflorg/medicaid/
uploadI7990-07.pdf
Kaprowy, T. (2012, August 31). Kentucky ranks third among
States in child obesity, a problem that has a broad scope
and deep roots. Retrieved from: http://kyhealthnews.
blogspot.com/2012/08/kentucky-ranks-third-im.html
Pediatric Practice Research Group., (2008). Promoting
Health for a Lifetime: Practice strategies in Primary
Care Management of Childhood Overweight and
Obesity Ed. 2. Consortium to Lower Obesity in Chicago
Children, Chicago, II.
Robert Wood Johnson Foundation. (2010, June 29).
Trust for America’s Health. Retrieved from: http://
healthyamericans.org/reports/obesity201O/relaese.
php?stateid-KY
Robinson, G. A., Geier, M., Rizzolo, D. & Sedrak, M. (2011).
Childhood obesity: Complications, prevention strategies,
treatment. Journal of the American Academy of Physician
Assistants, 24 (12). 58-63.
Singh, G., Kogan, M., & van Dyck, P. (2008). A multilevel
analysis of State and Regional disparities in childhood
and adolescent obesity in the United States. Journal of
Community Health, 33,90-102.
Truman, C. (2012, September 24). Recent report
on Kentucky’s obese future has experts seeking
solutions.
Retrieved
from:
http://www.kentucky.
com/2012/09/24/2349167/recent-report-on-kys-obesefuture.html
United States Census Bureau. (2012, September 18).
States and Country Quickfacts. Retrieved from: http://
quickfacts.census.gov/gfd/states/21000.htm
Page 6 • Kentucky Nurse
July, August, September 2015
Student Spotlight
Mine Workers, Heat Related Illnesses, and the Role
of the Occupational Health Nurse
Kimberly M. Bourne, MSN, RN, SANE, CEN
Student: University of Kentucky Occupational/Environmental
Health Nurse PhD Fellow
Faculty Mentor: Dr. Deborah Reed
Across the United States, workers in many occupations face weather
and related extreme conditions on a daily basis. Hot weather and manual
labor increase a person’s core body temperature. This heat gain comes
from a combination of environmental and self-generated (or internal) heat.
Environmental heat is both weather related and man-made, and internal
heat is produced from metabolic processes (Xiang, Bi, Pisaniello, & Hansen,
2014). But, it’s just not the heat that causes problems; it’s the humidity, too.
Each year thousands of workers suffer heat related illnesses as a result
of becoming overheated. Between June, 2013 and July, 2014, heat related
illnesses were responsible for more than 20 occupational worker deaths
in the U. S. (Occupational Safety and Health Administration [OSHA],
2014). Miners are at an increased risk for heat related illnesses. Workers
in underground mines are exposed to ambient temperatures and relative
humidity while performing their job duties decked out in safety equipment.
Surface mine workers endure outdoor environmental temperatures under
the same safety precautions. The aim of this paper is to outline the various
heat related illnesses suffered by coal miners, summarize the findings from
several published studies, offer suggestions to Occupational Health Nurses
for reducing heat exposure in miners, and propose future directions for
research.
Background
Worldwide, approximately 24,000 coal mines exist (World Coal
Association, n.d.). In the United States, there are 1,061 coal mines with
877 coal mines in the Appalachian region of the United States (U.S. Energy
Information Administration [EIA], 2015b). The Appalachian region stretches
from Southern New York to Northern Alabama and into Eastern Mississippi.
Central Appalachia (Kentucky, Tennessee, West Virginia, and Virginia) is
home to 525 coal mines: 248 underground mines and 277 surface mines
(EIA, 2015b). In 2013, 18,853 people were employed in underground Central
Appalachian mines, and 9,089 people were employed in Central Appalachian
surface mines (EIA, 2015a). Coal mining is considered one of the most
dangerous jobs in the world, and each day miners are exposed to a variety of
hazards, both fatal and non-fatal.
In 2014, there were 16 fatalities in coal mines across the United States
(Mine Safety and Health Administration [MSHA], n.d.a). Ten of the fatalities
occurred in the Appalachian region, and nine from the Appalachian
region were in Central Appalachia (MSHA, 2015). Most fatalities were
related to physical hazards such as falls, explosions, and equipment
accidents (Donoghue, 2004a). Heat, also considered a physical hazard, has
contributed to approximately 150 miners suffering from some type of nonfatal heat related illness (MSHA, n.d.c) such as heat stroke, heat exhaustion,
heat cramps, and heat rash (Centers for Disease Control and Prevention
[CDC], 2014; Lutz, Reed, Turner, & Littau, 2014; OSHA, n.d.). Heat related
illnesses are also the cause of injuries resulting from falls and equipment
operation accidents (Washington State Department of Labor & Industries,
n.d.) as workers develop symptoms such as sweaty palms, confusion,
seizures, dizziness, fatigue, hallucinations, and muscle cramps (CDC, 2014).
Types of Heat Related Illnesses
Heat Stroke
Heat stroke is the most serious heat related illness and can quickly result
in death if not treated (Lutz et al., 2014; OSHA, n.d.). It is associated with
central nervous system dysfunction and is characterized by a high core
body temperature (above 104°F), confusion, ataxia, nausea and vomiting,
tachycardia, tachypnea, and headache (Donoghue, 2004b; Keim, Guisto,
& Sullivan, 2002). Complications include: hemorrhage, acute renal failure,
rhabdomyolysis, and liver failure (Donoghue, 2004b; Glazer, 2005).
Heat Exhaustion
Heat exhaustion is the most common heat related illness and is the result
of dehydration. Signs and symptoms include: a core body temperature
between 98.6°F and 104°F, dizziness, weakness, headache, and syncope
(Donoghue, 2004b; Glazer, 2005). Complications are less severe than
heatstroke and include: hypotension, oliguria, tachycardia, and confusion
(Glazer, 2005).
Heat Cramps
Heat cramps are often the first sign of a heat related illness and are
characterized by involuntary contractions of the skeletal muscles. Heat
cramps are painful, can occur in the legs or abdomen, and usually last a
few minutes (Donoghue, 2004b; Keim et al., 2002).
Heat Rash
A Heat rash is the least serious heat related illness. It is the result of
clogged pores from exposure to high heat and humidity. It is characterized
by tiny red bumps, or blister like areas on the surface of the skin from sweat
trapped under the skin (Keim et al., 2002).
The Heat Effect on Miners
Heat is a common problem in the mining industry. Surface miners are
frequently exposed to high wet-bulb globe temperatures, especially during
the summer months when it can exceed 30°C (Hunt, Parker, & Stewart,
2013). “The Wet Bulb Globe Temperature (WBGT) is a measure of the heat
stress in direct sunlight, which takes into account: temperature, humidity,
wind speed, sun angle and cloud cover (solar radiation). This differs from
the heat index, which takes into consideration temperature and humidity
and is calculated for shady areas” (National Weather Service, 2015, para. 1).
Underground miners are vulnerable to heat accumulation as the result of
high heat flow from the earth, heat from virgin rock, and additional safety
equipment such as self-contained self-rescue apparatuses (MSHA, n.d.b;
Lutz et al., 2014; Xiang et al., 2014). Most heat related illnesses occur during
daylight hours when the temperatures are higher (Xiang et al., 2014). In a
study of three mine sites across northern Australia, 87% of surface miners
(n=91) and 79% of underground workers (n=56) reported experiencing
at least one symptom of a heat related illness during their shift, and 8182% reported symptoms more than once during their shift. Seventy-one
percent of surface miners were dehydrated prior to starting their shift with
similar numbers in underground miners (Hunt, Parker, & Stewart, 2013). In
a similar study of a mine blast crew in the tropics (n=15), 73% of workers
complained of at least one symptom of a heat related illness during their
shift, and 88% were dehydrated prior to the beginning of their shift (Hunt,
Parker, & Stewart, 2014). In each study, the dehydration status did not
improve during the shift (Hunt et al., 2013; Hunt et al., 2014). In the U.S.,
between January, 1983 and December, 2001, 538 mine workers reported at
least one symptom of a heat related illness during their shift, and 79.4% of
the incidents occurred during the summer months (Donoghue, 2004b).
The Occupational Health Nurse’s Role in
Combating Heat Related Illnesses
There are several factors that put miners at an increased risk for heat
related illnesses: hypohydration, increased body mass index (BMI), poor
aerobic fitness, and lack of heat acclimation (Brake, 2001; Donoghue,
Sinclair, & Bates, 2000). Occupational health nurses can help decrease
the risk of symptoms related to heat illnesses by providing education
and developing programs and policies to encourage hydration both prior
to and after worker shifts as a high number report to duty hypohydrated
and during shifts as they continue to deplete their fluids (Brake, 2001;
July, August, September 2015
Kentucky Nurse • Page 7
Student Spotlight
Kalkowsky
&
Kampmann,
2006).
Fitness
programs serve a dual purpose; they can help
decrease BMI and increase aerobic fitness as
higher BMI’s have been positively correlated with
an increase in heat illnesses (Donoghue & Bates,
2000; Lutz et al., 2014). The development of
acclimation programs and self-pacing programs
can reduce the incidences of symptoms of heat
related illnesses by promoting shorter work-rest
cycles, encouraging workers to rest more often,
working at slower rates in higher temperatures,
and reporting symptoms earlier (Donoghue et al.,
2000; Hunt et al., 2014; Xiang et al., 2014).
Conclusion
Most studies on heat related illnesses in
miners have occurred outside of the U. S. Those
studies have shown that a significant number
of mine workers reported at least one symptom
of a heat related illness during their assigned
shift. Dehydration was noted to be the leading
cause of heat exhaustion especially during the
summer months. Education and the development
of programs and policies by occupational health
nurses can help combat the incidences of heat
related illness symptoms. As limited data exist on
heat related illnesses in miners in the U.S., more
research is needed to determine the potential
effects of heat exposure on heat related illnesses
in mine workers in the Appalachian region of the
U. S.
References
Brake, R. (2001). Fluid consumption, sweat rates
and
hydration
status
of
thermally-stressed
underground miners and the implications for heat
loss and shortened shifts. Queensland Mining
Industry Occupational Health and Safety Conference.
Townsville, Australia. Retrieved from http://www.
pointhealth.com.au/pdf/Fluid%20consumption,%20
sweat%20rates%20and%20hydration%20status%20
of%20therm.pdf
Centers for Disease Control and Prevention. (2014). Heat
stress. Retrieved from http://www.cdc.gov/niosh/
topics/heatstress/
Donoghue, A. (2004). Occupational health hazards in
mining: An overview. Occupational Medicine, 54, 283289. doi:10.1093/occmed/kqh072
Donoghue, A. M. (2004b). Heat illness in the U.S. mining
industry. American Journal of Industrial Medicine, 45,
351-356. doi:10.1002/ajim.10345
Donoghue, A. M., & Bates, G. P. (2000). The risk of heat
exhaustion at a deep underground metalliferous
mine
in
relation
to
surface
temperatures.
Occupational Medicine, 50(4), 334-336. doi:10.1093/
occmed/50.4.259
Donoghue, A. M., Sinclair, M. J., & Bates, G. P. (2000).
Heat exhaustion in a deep underground metalliferous
mine. Occupational and Environmental Medicine,
57(3), 165-174. doi:10.1136\oem.57.3.165
Glazer, J. L. (2005). Management of heatstroke and
heat exhaustion. American Family Physician, 71(11),
2133-2140. Retrieved from http://www.aafp.org/
afp/2005/0601/p2133.pdf
Hunt, A. P., Parker, A. W., & Stewart, I. B. (2013).
Symptoms of heat illness in surface mine workers.
International
Archives
of
Occupational
and
Environmental Health, 86, 519-527. doi:10.1007/
s00420-012-0786-0
Hunt, A. P., Parker, A. W., & Stewart, I. B. (2014).
Heat strain and hydration status of surface mine
blast crew workers. Journal of Occupational and
Environmental Medicine, 56(4), 409-414. doi:10.1097/
JOM.0000000000000114
Kalkowsky, B., & Kampmann, B. (2006). Physiological
strain of miners at hot working places in German
coal
mines.
Industrial Health,
44,
465-473.
doi:10.2486/indhealth.44.465
Keim, S.M., Guisto, J.A., Sullivan Jr, J.B. (2002).
Environmental Thermal Stress. Annals Agricultural
and Environmental Medicine, 9(1), 1–15. Retrieved
from http://www.aaem.pl/pdf/aaem0201.pdf
Lutz, E. A., Reed, R. J., Turner, D., & Littau, S.
R. (2014). Occupational heat strain in a hot
underground metal mine. Journal of Occupational and
Environmental Medicine, 56(4), 388-396. doi:10.1097/
JOM.0000000000000107
Mine Safety and Health Administration. (2015). Coal
mining fatalities by state by calendar year. Retrieved
from United States Department of Labor: http://www.
msha.gov/stats/charts/coalbystates.pdf
Mine Safety and Health Administration. (n.d.a). Coal
fatalities for 1900 through 2014. Retrieved from http://
www.msha.gov/stats/centurystats/coalstats.asp
Mine Safety and Health Administration. (n.d.b). Heat
Stress in Mining. Retrieved from http://www.msha.
gov/s&hinfo/heatstress/manual/heatmanual.htm
Mine Safety and Health Administration. (n.d.c). Heat
stress...what to do. Retrieved from http://www.msha.
gov/s&hinfo/heatstress/heatstress.htm
Occupational Safety and Health Admisitration. (2014).
Heat Fatalities. Retrieved from https://www.osha.gov/
SLTC/heatillness/map_text.html
Occupational Safety and Health Administration. (n.d.).
Occupational heat exposure. Retrieved from https://
www.osha.gov/SLTC/heatstress/index.html
World Coal Association. (n.d.) Resources. Retrieved from
https://w w w.worldcoal.org/resources/frequentlyasked-questions/
National Weather Service. (2015). WetBulb Globe
temperature. Retrieved from http://www.srh.noaa.
gov/tsa/?n=wbgt
U.S. Energy Information Administration. (2015a).
Average number of employees by state and mine type,
2013 and 2012. Retrieved from U.S. Department of
Energy Annual Coal Report: http://www.eia.gov/coal/
annual/pdf/table18.pdf
U.S. Energy Information Administration. (2015b). Coal
production and number of mines by state and mine
type, 2013 and 2012. Retrieved from U.S. Department
of Energy Annual Coal report: http://www.eia.gov/
coal/annual/pdf/table1.pdf
Washington State Department of Labor & Industries.
(n.d.). Outdoor heat exposure. Retrieved from http://
w w w.l n i.w a.gov/s a fet y/topic s/ato z/he at st re s s/
default.asp
Xiang, J., Bi, P., Pisaniello, D., & Hansen, A. (2014).
Health impacts of workplace heat exposure: An
epidemiological review. Industrial Health, 52, 91-101.
Retrieved from http://www.ncbi.nlm.nih.gov/pmc/
articles/PMC4202759/
Page 8 • Kentucky Nurse
July, August, September 2015
Student Spotlight
Adapting Care to Culture: Aging in Agriculture
Anna Eastman, BSN Student
University of Kentucky, College of Nursing
Mentor: Dr. Deborah Reed – Good Samaritan
Endowed Chair in Community Health Nursing
Kentucky is home to over 76,400 farms (Census
of Agriculture, 2014). According to the National
Agricultural Statistics Service, the average age of
a farmer in Kentucky is 57.6. This is a reflection of
the nation’s increasing age of farm operators, which
has followed a 30-yearlong steady increase. With an
increasing age in an occupation that not only serves
as a means of income but as a lifestyle, the aging
farm population has specific needs when it comes
to health care. Acknowledgement of certain aspects
of the agricultural lifestyle can help nurses provide
culturally competent care.
Why does this population require attention?
The cultural characteristics of agriculture define
this population’s way of life. Usually, farmers
reside on family farms that have been lived on and
worked on by multiple generations of the same
family. The farm not only serves as a workplace but
also a home, which makes its upkeep the number
one priority for these farmers. It is not uncommon
for farmers to work well past the age of retirement
because of their commitment to their farm. For
these farmers, health is the ability to work and they
will choose to work until they are physically not able
to perform their farm tasks anymore (Reed, Ravens,
Conley, Westneat, & Adkins, 2012). According
to a survey that gathered information about
determinants of work hours on farmers ages 50 and
up in Kentucky and South Carolina, chronic health
problems only had a minor role in determining the
amount of hours worked (Marcum, 2011a).
Taking part in physical labor on a daily basis
defines the work of agriculture and it is not
surprising that farmers, ranchers, and other
agricultural managers were included in the top
10 deadliest jobs based on data from the Bureau
of Labor Statistics (Forbes, 2013). Farm work
routinely involves heavy lifting, climbing, working
with animals, and working with heavy machinery.
Farm work is dangerous, regardless of the age of
the farmer, and health problems that typically
accompany aging can exacerbate the risk that this
job carries. The human body may become less
capable to handle the same workload as it ages,
even though the work that a farm requires will
remain the same.
Common health problems for older farmers
include chronic bronchitis, emphysema, arthritis
and restless nights. From a study that evaluated
farm-work related injury of farmers age 50 and
over in Kentucky and South Carolina, it was
calculated that those who experienced 5 to 7
restless nights per week, operated machinery
on a highway, or climbed 8 feet or higher were at
significantly higher odds of sustaining a farmrelated injury (Marcum, 2011b). Other health
problems, such as musculoskeletal disorders and
arthritis, can limit the amount of physical labor a
farmer can perform. Moreover, hearing and visual
deficits also place the older farmers at risk. If
they are not able to hear or see potential danger,
they may not be able to respond appropriately and
avoid injury.
Currently, there is limited research that focuses
on the specific educational and health care needs
of the aging farmer population. However, nurses
can use the information that is currently available
and increase the culturally appropriate care.
What can nurses do?
Nurses can use the knowledge of the risks this
occupation faces, the physical limitations of aging,
and farmer’s commitment to farm work to tailor
the older farmer’s care. Nurses can apply this
knowledge to the education they may provide to
older clients who are still working on their farms.
Nurses should provide education about preventive
measures older farmers can take to protect
themselves in the field.
Lifestyle tips such as stretching before
work, good sleep hygiene, taking frequent
water breaks, using good body mechanics, and
proper communication (International Society
for Agricultural Safety and Health, 2014) while
at work may help older farmers avoid injury.
Stretching before physical labor may help reduce
the incidence of activity-based injuries. Good
sleep hygiene can help ensure that aging farmers
are alert when they start their day so they can
operate machinery to the best of their ability.
Frequent water breaks can prevent dehydration,
especially when the farmer is working in hot
conditions. These breaks may provide relief from
labor intensity, thereby reducing physical and
psychological stress. Good body mechanics may
help prevent unnecessary strain on the worker’s
back when lifting. Finally, having a means of
communication when out alone in the field can
help the farmer call for help if necessary. If nurses
make farmers aware of the small changes they can
make to avoid injury, their work can become safer
and healthier.
Preventive measures in addition to education
can help make farming even safer for elderly
farmers who continue to work. An up to date
tetanus immunization can help protect the farmer
against this deadly disease if a laceration or other
injury occurs on the job, since it is likely that the
wound will be dirty. Hearing and vision screenings
can identify deficits so measures can be taken to
accommodate those deficiencies. Additionally, wide
brim hats and sunscreen can help protect against
the sun’s harmful rays while farmers are working
outside (International Society for Agricultural
Safety and Health, 2014).
Conclusion
As a nurse it is important to be aware of the
needs of the populations you work with, and
nurses in Kentucky should be aware of the special
needs and the culture of farmers who require
health care services. Farmers tend to work until
failing health or serious injury forces them to stop.
When nurses understand the farming culture,
and have knowledge of the available research and
resources, nurses can more successfully identify
health risks for these clients and provide better,
more focused, culturally attentive care.
Resources that are currently available for
nurses to use to support their care of the farm
population include the AgNurse Facebook page,
AgriSafe, and AgrAbility. The AgNurse Facebook
page
(www.facebook.com/Agriculture.nurse)
provides up to date information on happenings
in Kentucky regarding farm safety and health.
AgriSafe (www.agrisafe.org) is a website run by
health professionals and educators concerned
with the health and safety of farm families and
provides free educational programs for health care
professionals. Finally, AgrAbility (www.agrability.
org) provides direct assistance and education to
help minimize obstacles and improve quality of life
for farmers with disabilities. These websites may
provide the most recent and accurate information
regarding health and safety in Kentucky and can
be used by nurses to stay on top of change in care
for this group.
References
Census of Agriculture (2014). U.S. farmers and farmers.
Retrieved
from
http://www.agcensus.usda.gov/
Publications/2012/Preliminary_Report/Highlights.pdf
International Society for Agricultural Safety and Health
(2014). Aging farmers: 10 tips for your health and
safety. Retrieved from http://isash.org/wp-content/
uploads/2014/09/5-ISASH-Aging-Farmers.pdf
Reed, D.B., Ravens, M.K., Conley, C.C., Westneat, S., &
Adkins, S.M. (2012). Farm Elders Define Health as the
Ability to Work. Workplace Health and Safety, 60, 345361.
Smith,
J.
(2013).
America’s 10 deadliest jobs.
Retrieved
from
http://www.forbes.com/sites/
jacquelynsmith/2013/08/22/americas-10-deadliestjobs-2/
Marcum, J.L., Browning, S.R., Reed, D.B., Charnigo,
R.J. (2011a) Determinants of work hours among a
cohort of male and female farmers 50 years and older
in Kentucky and South Carolina (2002-2005). Journal
of Agromedicine, 16(3): 163-173.
Marcum, J.L., Browning, S.R., Reed, D.B., Charnigo,
R.J. (2011b) Farmwork-Related Injury Among Farmers
50 Years of Age and Older in Kentucky and South
Carolina: A Cohort Study, 2002-2005. Journal of
Agricultural Safety and Health, 17(3): 259-27.
Go to www.clarkregional.org
to apply now!
Human Resources: 859.737.8276
175 Hospital Drive, Winchester, KY 40391
July, August, September 2015
Kentucky Nurse • Page 9
Student Spotlight
Electronic Cigarettes
Madison Shiner
University of Kentucky
Kentucky has more than 930,000 adult smokers
(America’s Health Rankings, 2014). There is debate
on whether electronic cigarettes are an effective
smoking cessation tool or if they are a gateway for
adolescent tobacco use (Jolly & Tavernise. 2014). The
purposes of this review were to examine the health
effects of electronic cigarettes and the potential for
electronic cigarettes to be a gateway to tobacco use
in adolescents.
Background
More than a quarter of a million non-cigarette
smoking youth used electronic cigarettes in 2013
(CDC, 2014). Tobacco cigarettes are regulated
to protect the youth, but there are no similar
regulations for electronic cigarettes Electronic
cigarettes are being marketed in the same way that
conventional cigarettes were originally marketed
before the media ban in the 1970’s (Dutra & Glantz,
2014). Youth exposure to electronic cigarettes on
television increased 256% from 2010 to 2013 (Duke,
et al., 2014). Electronic cigarettes are also flavored
in order to appeal to adolescents. With the lack of
advertising regulations and the aesthetic appeal
to adolescents, the number of adolescents using
electronic cigarettes is expected to increase (CDC,
2014). Adolescents who used electronic cigarettes
were 20% more likely to smoke conventional
cigarettes in the future than their cohorts who did
not use electronic cigarettes (CDC).
Method of Review
PubMed, MEDSCAPE, CDC, and EBSCO Host
were reviewed using key words: electronic cigarettes,
adolescents, smoking cessation, regulations, and
advertising. Only articles published in English and
within the past five years were included in this
review.
Summary of Findings
Health Impact of Electronic Cigarettes
Electronic cigarettes can contain a lethal amount
of nicotine if ingested or absorbed through the
skin (Chen, 2012). Other adverse events that have
been reported include “pneumonia, disorientation,
seizures, hypotension, second degree burns to the
face, chest pain and rapid heart rate, loss of vision,
headache, cough, dizziness, and pleurisy” (Chen,
2012, p.615). Electronic cigarettes may also increase
the risk for viral respiratory infections because they
decrease molecules that protect the airway against
microbial pathogens (Wu et al., 2014).
Second hand vapor from electronic cigarettes can
also be harmful to bystanders (Offermann, 2014).
Second hand vapor exposure risk was quantified
using the California Office of Environmental
Health Hazard Assessment Chronic Reference
Exposure Guidelines (CRELs) and California
OSHA
occupational
eight-hour
Permissible
Exposure Guidelines. Four of the nine chemicals in
electronic cigarette vapor are either lung irritants
or carcinogens (Offermann, 2014). Other chemicals
of concern are the glycol carriers, which can form
formaldehyde (Offermann, 2014). The “vapor” that
is being inhaled is actually an aerosol that deposits
on the surface of respiratory tract cells (Offermann,
2014). There are up to 400 different brands of
electronic cigarettes and some with the higher
voltage battery can produce nicotine absorption
similar to that of a conventional cigarette (Chen,
2012).
Smoking Cessation
Electronic cigarettes may be effective as a
smoking cessation device (Hajek et al, 2014).
However, electronic cigarettes are sometimes being
used in combination with conventional cigarettes
and can encourage adolescent smoking (Dutra
& Glantz, 2014). A study to compare efficacy of
electronic cigarettes to other smoking cessation tools
was conducted with one group of smokers using
nicotine patches, another group using electronic
cigarettes with nicotine, and the third group using
electronic cigarettes without nicotine. There was no
statistically significant difference in cessation rates
among the groups (Bullen et al., 2013).
Tobacco Regulations
Targeted advertising and a lack of regulatory
standards increase the risk of “renormalizing”
smoking (Pepper et al, 2014). Electronic cigarettes
are not held to the same regulatory standards
as conventional cigarettes, i.e. clean air policies,
flavoring, advertising and packaging (Grana & Ling,
2014). Smoking advertisements have been banned
from television since the Public Health Cigarette
Smoking act was passed in 1970 (CDC, 2009). This
act prohibits the advertisement of cigarettes on the
television or radio and requires warning labels on
packages. Labels on electronic cigarettes often list
incorrect nicotine concentrations and have few or no
health warnings (Grana & Ling, 2014).
Expert Recommendation
Health organizations agree that electronic
cigarettes should be regulated. The World Health
Organization (WHO) has stated that regulations are
needed to prevent electronic cigarettes marketing
that targets younger people and to lower risks of
harm to users and nonusers (WHO, 2014). Electronic
cigarettes should be included in smoke free policies
because the aerosolized chemicals pose health risks,
create a smoky haze that may cause confusion with
the policies set in place for conventional cigarettes,
put people at risk for second hand smoke and keep
smokers addicted (Hahn, Riker & Brown, 2014).
References
America’s Health Rankings. 2014. Kentucky Annual
State Health Ranking. Retrieved from http://www.
americashealthrankings.org/KY
Bullen, C., Howe, C., Laugesen, M., McRobbie, H., Parag, V.,
Williman, J. & Walker, N. (2013) Electronic cigarettes for
smoking cessation: A randomized controlled trial. The
Lancet, 382(9905), 1629-1637.
Center for Disease Control and Prevention. September 8,
2014. Press Release: More than a Quarter-million youth
who had never smoked a cigarette used e-cigarettes
in 2013. Retrieved from http://www.cdc.gov/media/
releases/2014/p0825-e-cigarettes.html
Center for Disease Control and Prevention. (2009.) The
Power of Prevention: Chronic Disease…the public health
challenge of the 21st century. Retrieved from http://
w w w.cdc.gov/ch ron icd ise a se/p d f/2 0 0 9 -p ower- ofprevention.pdf
Chen, I. (2012) FDA Summary of adverse events on
electronic cigarettes. Nicotine and Tobacco Research,
15(2), 615-616.
Duke, J., Lee, Y., Kim, A., Watson, K., Arnold, K.,
Nonnemaker, J. & Porter, L. (2014).
Exposure to electronic cigarette television advertisements
among youth and young adults. The Official Journal of
the American Academy of Pediatrics. 134(1), 29-36.
Durmowicz, E. (2014) The impact of electronic cigarettes on
the paediatric population. Tobacco Control, 23(S2), 41-46.
Dutra, L.M. & Glantz, S.A. (2014). Electronic cigarettes
and conventional cigarette use among US adolescents.
Journal of American Medicine Association of Pediatrics,
168(7), 610-617. doi:10.1001/jamapediatrics.2013.5488
Grana, R., Ling, P. (2014) Smoking revolution. American
Journal of Preventive Medicine. 46(4), 395-403.
Hahn, E., Riker, C., & Brown, H. (2014) E-cigarettes:
What health professionals need to know. Retrieved
from
http://www.mc.uky.edu/tobaccopolicy/KCSP/
OnePagers/EcigNeedtoKnowHealthProf.pdf
Hajek, P., Etter, J., Benowitz, N., Eissenberg. T, McRobbie.
H. (2014) Electronic cigarettes: Review of use, content,
safety, effects on smokers and potential for harm and
benefit. Addiction. doi: 10.1111/add.12659
Jolly. D., Tavernise. S. (August 2014.) World Health
Organization Urges Stronger Regulation of Electronic
Cigarettes. The New York Times.
Offermannn, F. (2014) The hazards of E-Cigarettes. Ashrae
Journal. 56(6), 38-44.
Pepper, J., Emery, S., Ribisl, K., Southwell, B., Brewer, N.
(2014) Effects of advertisements on smokers’ interest in
trying e-cigarettes: The roles of product comparison and
visual cues. Tobacco Control, 23(S3), 31-36.
World Health Organization. 2014. Backgrounder on WHO
report on regulation of e-cigarettes and similar products.
Retrieved from http://www.who.int/nmh/events/2014/
backgrounder-e-cigarettes/en/
Wu, Q., Jiang, D., Minor, M., Chu, H. (2014). Electronic
cigarette liquid increases inflammation and virus
infection in primary human epithelial cells. PLoS ONE,
9 (9),
Professional Nursing in Kentucky
* Yesterday * Today * Tomorrow
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FAX: 502-637-8236
E-mail: [email protected]
Page 10 • Kentucky Nurse
July, August, September 2015
KNA 2015 Election
Biographical Information for 2015 Election
The following is the biographical information
furnished by the candidates on the 2015 ballot for
election to service. Ballot will be mailed to all active
KNA members in early August 2015. Please keep
this information for easy reference when your ballot
arrives. You can also find this information on the
KNA Website
BOARD OF DIRECTORS AND OFFICERS
President- Elect (Vote for 1)
Kathy K Hager, DNP, APRN, FNP-BC, CDE
Present Position: Bellarmine University
Type of Position: Nursing Faculty
Area of Expertise: Nurse Practitioner; Educator;
Consultant; CE Planner
Education: University of Kentucky, Lexington, KY
- Doctorate of Nursing Practice (DNP), August, 2006;
University of Kentucky, Lexington, KY-Primary Care
Nurse Practitioner Post Clinical Scholars component
in the Graduate Nursing Program (29 hours past
Masters, July, 1996); University of Kentucky,
Lexington, KY -Master of Science in Nursing (Focus
on education and gerontology), May, 1976; University
of Kentucky, Lexington, KY - Bachelor of Science in
Nursing, May, 1972
Professional
Organizational
Activities:
Kentucky Nurses Association (KNA) Board of
Directors; Treasurer, 2010-2014; KNA Board
of
Directors,
2006-2008,
2014-2016;
Chair,
Membership,
Recruitment
and
Retention
(2006-present),
Member
Convention
Planning
(2000-2010; 1999-2006; Co-Chair 2001); KNA
Governmental Affairs Cabinet, 2003-2006; KNA
Board of Directors, 2000-2002, Chair, Nurse
Practice Cabinet; KNA District 1 treasurer, 1989;
KNA Centennial Committee, 2004-2006; Member
KNA, ANA since 1988; Delegate to the ANA
Statement: Since 1988, I have been a KNA/
ANA member. With each passing year, I get more
enthused about a dream that transforms nursing.
I see it happening now, as our professional
organization focuses on the needs of our
commonwealth, moving us toward excellence and
equity in care. This year KNA will be financially
supporting doctoral level nursing students in
studying Kentucky-specific needs, including the
value of school nurses, and the best in care for our
aging population. I want to be a part of this new
vision, new endeavors, and new dreams.
Joe Middleton, MSN, APRN, CEN, CC/NRP
Present
Position: Team
Health
Type
of
Position:
Emergency Department
Area of Expertise: Head
Nurse, Manager, Paramedic
Education:
Spalding
University,
Post
Master’s
Certificate
(Family
Nurse
Practitioner) and Master of
Science in Nursing (Nurse
Education); Western Kentucky University, Bachelor
of Science in Nursing; Associate of Applied Science
(Paramedicine) and Associate of Science in Nursing;
Central Kentucky EMS Training, Licensed EMTParamedic
Professional
Organizational
Activities:
Currently Serving as KNA Treasurer; previously
served on the Board of Directors as the
Governmental Affairs Cabinet Chairperson; member
of KY Nurses REACH Chapter
Statement: I have greatly enjoyed serving the
KNA as Treasurer of the Board of Directors and
as a Director. During my three years serving on
the Board in these roles, I have had the honor of
working closely with KNA staff, ANA staff and Board
leadership to develop our successful membership
initiative and a solid strategic plan for growth and
relevance in the coming years. This hands-on
education and experience has provided me with a
foundation and understanding of the KNA and the
challenges that we face as the nursing community,
all of which prepares me to take on the challenge of
being a KNA President who is connected to you, the
member. I believe that our organization has reached
a very vital and pivotal point and that the KNA is on
the brink of great things. It is imperative that elected
officers and staff work diligently to maintain and
secure the voice of every nurse and every specialty of
nursing. I am committed to serving our community
and to helping you and every nurse raise your voice
and our voice through the growth and strength of
our association. I ask for your vote and support in
electing me to serve as President- Elect of the KNA.
Vice President (vote for 1)
Dana Manley, PhD, FNP, Women’s Health NP
Present Position: Murray State University
Type of Position: Associate Professor
Area of Expertise: Educator, Nurse Practitioner,
Women’s Health , Public Health
Education: University of Tennessee, Memphis,
TN, 2008 – PhD in Nursing; Murray State University,
Murray, KY, 1998 – MSN; Murray State, Murray, KY,
1991 - BSN
Professional Organizational Activities: Ethics
& Human Rights Committee 2012 to present;
District and Western KY Chapter member
Statement: I welcome the opportunity to serve as
Vice President of the Kentucky Nurses Association.
As a nurse educator and a public health nurse, I am
committed to the development of caring professional
nurses in the workforce and to improving the
health of populations. I am presently a member
of the Ethics & Human Rights committee and am
interested in expanding my service to KNA and its
constituents. As Vice President, one of my goals
is to develop collaborative relationships and work
in conjunction with others to promote the role of
registered nurses across the Commonwealth and to
support research and legislative efforts.
Jo Ann M. Wever, MSN
Present Position: Doctoral Student
Area of Expertise: Staff Nurse, Educator, Chief
Nurse Two Army Reserve Medical Units, Awarded “A”
proficiency designation for excellence in education by
the Surgeon General of the United Stated Army
Education: University of Kentucky, MSN; East
Carolina University, BSN; Sandhills Community
College, ADN; Western Kentucky University, Current
Doctoral Student
Professional Organizational Activities: District/
Chapter: District President, Nightingale Chairperson
State: Director on Board of Nursing (2012-2014, 20142016); Liaison to Nominating Committee
Statement: Having served as a director of KNA,
I now am running for Vice President. I think that I
can continue to serve the membership by being
Vice President. I ask for your vote. I promise to
continue to represent the interest of all nurses in the
Commonwealth.
Secretary
Beverly Rowland, PhD(c), RN
Present Position: Cambellsville University
Type of Position: Dean of the School of Nursing
Area of Expertise: Educational Administrator
Education: Henderson Community College,
ADN; McKendree College, BSN; Western Kentucky
University, MSN; Indiana University School of
Nursing, PhD candidate
Professional Organization Activities: KNA
Professional Practice and Nursing Advocacy Cabinet
(2009-2013); KNA Board of Directors Secretary
(2013-present); member, REACH Chapter
July, August, September 2015
Kentucky Nurse • Page 11
KNA 2015 Election
Statement: I enjoy serving on the KNA Board
of Directors and would like the opportunity to be
part of the exciting work that is going on in the
association right now. We need to continue to bring
in new individuals with vision for the organization
and to support the efforts to improve the profession
for nurses across the state of Kentucky. I seek your
continued support for the KNA and your vote to
allow me to continue to serve.
Directors (Vote for 2)
Jenny Chandler, RN, MSN,CCRN, CNS
Present Position: Norton Healthcare
Type of Position: Manager of the Scholar
Program
Area of Expertise: Clinical Specialist
Education: University of Florida, BSN, 1979;
University of Florida, MSN, CNS, 1988; CCRN since
1987
Professional Organizational Activities:
Statement: I am a Clinical Nurse Specialist,
therefore my aim by profession and education is to
improve patient outcomes. I manage the Scholar
Program at Norton Healthcare and teach clinicals
at several universities. Over time and with the
opportunity to work with new graduates on a
routine basis, I have come to realizes that in order
to improve patient outcomes I must work toward
improving educational and professional outcomes. I
also bring to the table many years of management in
the hospital setting – always keeping up with clinical
needs and skills. I hope to have the opportunity
to share my goals with nurses and policy makers
throughout Kentucky and represent quality care to
an even larger community.
Teena Darnell, DNP, MSN, RN
Present Position: Bellarmine University
Type of Position: Nursing Faculty
Area of Expertise: Educator
Education: Bellarmine University, DNP, MSN;
University of Louisville, BSN; Jefferson Community
College, AA
Professional
Organizational
Activities:
District/Chapter: District 1 Secretary State:
Governmental Affairs Cabinet, Convention Program
Planning committee, Membership Recruitment and
Retention Committee, KYN PAC, Director on KNA
Board of Directors National: KNA Delegate to ANA;
KNA Representative at ANA Membership Assembly
Statement: Since graduating from nursing
school in 1987, I have been a longtime volunteer
and advocate for the Kentucky Nurses Association.
In fact, my affiliation with KNA has played a large
role in my life. I have participated on numerous
committees and assumed many board positions
at both the state and district level. As an active
member, I have spent much time and energy
in facilitating membership growth as well as
organizational stability. I have weathered many
storms with KNA and believe my knowledge and
experience has allowed me to make valuable
contributions to the association. With this
appointment, I believe I will bring an objective yet
relevant perspective to the board of directors. I look
forward to contributing to KNA’s leadership team
once again and for the opportunity to serve the
members. As part of my consent to serve, I humbly
request your support.
Michael Wayne Rager, DNP, PhD(c), MSN, FNP-BC,
APRN, CNE
Present Position: Daymar
College
Type of Position: Dean of
Nursing & Campus Dean
Area
of
Expertise:
Administrator, Educator, Nurse
Practitioner
Education: University of
Colorado at Colorado Springs,
DNP; North Central University,
PhD(c); Spalding University,
FNP; University of Southern
Indiana, MSN; University of Louisville, BSN;
Madisonville Community College , AAS/ADN/AA;
Madisonville Health Technology Center, Diploma of
Practical Nursing
Professional Organizational Activities: KNA
Vice President, ANA Alternate Delegate
Statement: It would a great honor to serve KNA
as Director, as my prior and current appointment
as Vice-President has provided even more value to
my practice, ability to reach students regarding
the value of professional organization membership,
and work on issues that influence patient care
and nursing practice. I believe that my efforts
during my last appointment, intertwined with a
variety of experiences as a clinician, educator, and
diversified educational preparation have prepared
me to effectively help continue to lead KNA, and
also have met the position requirements as detailed
within the KNA by-laws. I am enthusiastic, willing to
work diligently to represent KNA/ANA constituents
with the highest regard and be sensitive to issues
affecting the profession. Please provide me with the
utmost consideration and allow me the awesome
opportunity to continue serving and representing
our organization
ETHICS & HUMAN RIGHTS
CHAIRPERSON
Clara Dorris, RN, BSN, MS
Present Position: KCTCS & Daymar College
Type of Position: Adjunct Faculty
Area of Expertise: Educator
Education: Owensboro-Daviess County Hospital
School of Nursing- Diploma-1969; Murray State
University – Bachelor of Science in Vocational
Technical Education-1979; University of Evansville
– Bachelor of Science in Nursing-1982Murray State
University – Master of Science in Education
Professional Organizational Activities: Chair,
KNA Ethics & Human Rights Committee, Member of
the Green River Chapter
SECRETARY (Vote for 1)
Laurie B. Heckel, RN, BSN, SMQT Certified
Present Position: Commonwealth of KY Office of
the Inspector General
Type of Position: Assistant Regional Program
Manager
Area of Expertise: Nurse Consultant Inspector
Education:
Somerset
Community
CollegeADN-1986; Western Kentucky University-BSN-2008
Professional Organization Activities:
Statement: In 29 years of nursing, I have
encountered many ethical dilemmas. Nurses are
always advocates for those we serve; however, we
do not always have clear solutions for reconciliation
of these concerns. If elected, my goal is to promote
well-recognized and easily accessible avenues for
guidance when faced with difficult situations.
Additionally, I am passionate about finding ways
to address human trafficking in our state and
throughout the country. I believe the Ethics &
Human Rights Committee is an excellent channel for
exploring these and other broad topics while seeking
to develop specific solutions to specific problems.
MEMBER AT LARGE (Vote for 2)
Ann W. Christie, MSN, RN, NE-BC
Present Position: TJ Samson Community
Hospital
Type of Position: Director of CCU/CTU/Cardiac
Services
Area of Expertise: Supervisor
Biographical Information continued on page 12
Page 12 • Kentucky Nurse
July, August, September 2015
KNA 2015 Election
Biographical Information continued from page 11
Education: Western KY University, Associate of
Science in Nursing. 1995; McKendree University,
Bachelor of Science in Nursing, 2008; McKendree
University, Masters in Nursing Administration, 2010
Professional
Organizational
Activities:
KNA Nominating Committee (2010-2011), KNA
Professional Practice and Nursing Advocacy (20112013)
Whitney Van Vactor, BSN, RN
Present Position: Baptist Health Louisville
Type of Position: Clinical Outcomes Nurse
Area of Expertise: Quality/Clinical Outcomes
Education: Centre College, BA/Government;
Bellarmine University, BSN, 2004; Bellarmine
University,
MSN
Administration,
expected
graduation 2016
NOMINATING COMMITTEE (Vote for 3)
Connie D. Lamb, PhD, RN, CNE
Present Position: Eastern Kentucky University
Type of Position: Tenure Track Faculty,
Associate Professor
Area of Expertise: Educator
Education: Berea College 1996, BSN; Eastern
Kentucky University, 2002, MSN; University of
Kentucky, 2008, PhD
Karen Profitt Newman, EdD, MSN, RN, NEA-BC
Present Position: Baptist Health Louisville
Type of Position: Vice President, Chief Nursing
Officer
Area of Expertise: Administrator
Education: Spalding University, Doctorate in
Educational Leadership; University of Evansville,
MSN; Vanderbilt University, Clinical Specialty in
Oncology Nursing; University of Kentucky, BSN
Professional Organizational Activity: Former
member of the KNA Board of Directors
Statement: As a long time KNA member with a
significant network of colleagues across the state,
from Paducah to Pikeville, I am pleased to serve
on the nomination committee to identify members
who can bring leadership expertise to our state
association.
Rhonda Vale, MSN, RN
Present Position: Campbellsville University
Type of Position: Nursing Instructor
Area of Expertise: Educator
Education: University of Maryland University
College, 1999, AA Management Studies; Austin Peay
State University, 2002, BSN; Western Kentucky
University, 2012, MSN
Maribeth Wilson, PhD (c), MSN, MSPH, RN
Present Position: Western Kentucky University
Type of Position: Faculty
Area of Expertise: Educator
Education: University of South Africa, PhD
(2015); University of Alabama Capstone College
of Nursing, MSN; University of Madison College
of Public Health, MSPH; Barry University, BSN;
University of Western Ontario, BS-Molecular Biology
Statement: I welcome the opportunity to
contribute to the work of KNA/ANA in a leadership
position. I am a dedicated member of the KNA. If
elected, I would bring the knowledge that I have
gained in various leadership roles outside of the
KNA. I have served as the leader of my Sigma Theta
Tau chapter and have provided leadership on a
variety of School and University-wide committees.
I have a strong commitment to nurturing
collaborative relationships with other departments
and organizations. If elected as a member of the
Nominating Committee, I would use my leadership
experience to initiate the exploration of ways the
Nominating Committee may best meet the needs and
recognize the contributions of nurses across their
careers.
EDUCATION & RESEARCH
NURSE ADMINISTRATOR (Vote for 1)
Marcia Hobbs, DSN, RN
Present Position: Murray State University
Type of Position: Dean of the School of Nursing
Area of Expertise: Education Administrator
Education:
University
of
Alabama,
DSN;
University of Hawaii, MS; DePauw University, BSN
Professional Organizational Activities: MO
STTI Executive Board; MO Nurses Association
Foundation; VP of the MO Association of Schools of
Nursing
Susan E. Nesmith, APRN, MSN, RN
Present Position: Hardin Memorial Health
Type of Position: Employee Health & Wellness
Manager
Area of Expertise: Nurse Practitioner &
Supervisor
Education: ECC, ADN; University of Kentucky,
BSN; University of Louisville, MSN
Statement: I would like to represent nurses
and begin to add more community involvement for
nurses.
University of the
Cumberlands
RN-BSN Program
ê $199/credit hour
ê 100% online
ê 38 credit hours
ê Complete in as little as 12 months
Graduate Admissions 1-800-343-1609
www.ucumberlands.edu
NURSE FACULTY (Vote for 1)
Jacquelyn Reid, MSN, EdD, APRN, CNE
Present Position: Indiana University Southeast
Type of Position: Interim Dean and Professor
Area of Expertise: Educator
Education: St Anthony Hospital, Diploma in
Nursing; Indiana University School of Nursing,
BSN; IU School of Education, EdD; Case Western
University, MSN
Professional Organizational Activities: KNA
Past-President; KNA Board of Directors; Education &
Research Cabinet; CE; District 1 Board of Directors
Statement: I have served on the Education
and Research Cabinet for the past 2 years. I enjoy
reading the submissions for the conferences.
STAFF NURSE (Vote for 1)
Kim Bourne, MSN, RN, SANE, CEN, EMT-B
Present Position: Western Kentucky University &
Greenview Hospital
Type of Position: Instructor at WKU; House
Supervisor at Greenview
Area of Expertise: Educator, Staff Nurse &
Supervisor
Education: University of Kentucky, PhD (c);
Western Kentucky University, MSN; St. Francis
College, BSN
Professional Organizational Activities: Chair,
REACH Chapter; Education & Research Cabinet
Statement: I have been a nurse for 19 years. In
that time I have seen many changes in nursing.
I feel that this position will help me stay current
on trends, challenges and changes that go along
with our chosen profession. It will also allow me to
be part of the decision making process regarding
the recommendations being made about the laws
currently in place. My goal is to continue gaining
knowledge about changing processes and laws and
stay actively involved in order to make informed
decisions that will improve the care of patients.
GOVERNMENTAL AFFAIRS CABINET
STAFF NURSE (Vote for 1)
Anne Sahingoz, LPN, RN, BSN, MSN, Ed & ABD
Present Position: St. Catharine College & Norton
Healthcare
Type of Position: Nursing Instructor & Charge
staff
Area of Expertise: Educator, Staff Nurse, and
Charge Nurse
Education:
Walden
University,
DNP
(c);
Chamberlain College of Nursing, BSN, MSN;
Spencerian College, LPN, ADN
Professional Organizational Activities:
Statement: I want to engage in active service
with the KNA as a means to facilitate the continuum
of empowering Kentucky nurses through active
fellowship and recruitment. In fellowship, we can
organize mentorships, advance nursing interests
and endow support throughout all levels of the
association. It is through fellowship that we as a
body can advance the profession of nursing. The
Mission & Vision of the KNA reflects elevation of
practice/science and theory as well as involvement in
the service of others throughout all service domains
including political. I want to collaborate both within
and without the KNA to achieve these expectations
and enhance them. Thank you.
Michelle Quisenberry, RN, MSN, APRN, NP-C
Present Position: Cornerstone Family Health, LLC
Type of Position: Nurse Practitioner
Area of Expertise: Nurse Practitioner
Education: University of Southern Indiana, Post
Masters Psych/Mental Health Nurse Practitioner,
expected graduation 2015; University of Southern
Indiana, MSN/Nurse Practitioner, 2010; University
of Southern Indiana, MSN, 2004; Madisonville
Community College, ADN, 2002
Professional Organizational Activities: District
11 Treasurer
MEMBER AT LARGE (Vote for 2)
Carla Hamilton, MSN, RN, NE-BC
Present Position: St. Elizabeth Healthcare
July, August, September 2015
Kentucky Nurse • Page 13
KNA 2015 Election
Type of Position: Unit Manager – Falmouth
Chemical Dependency
Area of Expertise: Psychiatric & Mental Health;
Supervisor
Education: Maysville Community College, ADN;
Western Governor’s University, BSN, MSN
Professional
Organizational
Activities:
Northern KY Chapter President; District 3 VP;
Poster Presenter, KNA Conference; Attendee at ANCC
conference
Statement: I have always been active in
community/school organizations and served on
many committees/councils within my personal
and professional careers. I currently serve as
a volunteer for 4-H Extension office (20yrs);
Scholarship Committee; KNA Northern KY Chapters
as chairperson and various committees with my
position.
I am resilient and dedicated. I believe in “paying
it forward” and that hard work gets rewards. My
main goal later in life was to become a registered
nurse. Four years later I obtained an MSN, NEBC certification, and the manager of a chemical
dependency facility.
I want to be a part of, let my voice be heard, and
advocate for people who cannot do it themselves. As
a behavioral health nurse, I can bring a different
perspective to the table.
Jennifer Miller, PhD (c), MSNEd, RN
Present Position: University of Kentucky
Type of Position: PhD candidate & Research
Assistant
Area of Expertise: Educator & Researcher
Education: Midway College, ADN; University
of Kentucky, BSN; Indiana Wesleyen, MSNEd;
University of Kentucky, PhD(c);
Statement: I have served as Secretary of the
Government Affairs Cabinet during the last few
years. I would like to remain in my position with
the GA Cabinet as I feel that there is much work to
be done in the state of Kentucky regarding health
legislation. Thank you for considering me for this
position.
Jerri Passo, MSN, RN-BC
Present Position: Kentucky One Health-Flaget
Memorial Hospital
Type of Position: Education Coordinator
Area of Expertise: Educator
Education: University of Phoenix, MSN; Indiana
University, BSN
PROFESSIONAL NURSING PRACTICE &
ADVOCACY CABINET
CLINICAL PRACTICE STAFF NURSE (Vote for 1)
Loretta Elder, MSN, RN, CNE
Present Position: Madison Community College &
Baptist Health Madison
Type of Position: Associate Professor of Nursing
& Staff Nurse
Area of Expertise: Educator & Staff Nurse
Education: University of Southern Indiana, MSN
Nursing Education; Murray State University, BSN;
Madisonville Community College, ADN; Madisonville
Vocational and Technical School, LPN
Professional Organizational Activities: District
11 President; member of the Professional Nursing
Practice and Advocacy Cabinet
Statement: I would like to ask for your vote
as I seek re-election to the Nursing Practice and
Advocacy Cabinet during this election. I am a strong
advocate for nursing and believe that groups can
make a difference. I have been a nurse since 1978
and love advocating for our profession and for our
patients. I currently work as a nurse educator in an
associate degree nursing program and continue to
work as a staff nurse in a hospital based ambulatory
surgery center. I want to thank you in advance for
considering me for this position.
CLINICAL PRACTICE (Vote for 1)
Jennifer Waterbury, RN, BSN, CM,LNC, MHA(c)
Present
Position:
Health
Corporation
of
American
Type of Position: RN Clinical EHR Test Analyst
Area of Expertise: Nursing Informatics
Education: Western Kentucky University, BSN,
MHA(c); St. Catherine College, Associate’s Degree in
Nursing
Professional Organizational Activities: KNA
Professional Nursing Practice & Advocacy Cabinet
Danette Culver, MSN, RN, ACNS-BC, CCRN
Present Position: Norton Healthcare
Type of Position: Med/Surg CNS
Area of Expertise: Clinical Specialist
Education: Indiana University-Purdue University
Indianapolis, MSN; University of Evansville, BSN
Professional Organizational Activities: ANA
Committee on Nursing Practice Standards
ADMINISTRATIVE ROLE (vote for 1)
Betty Kuiper, PhDc, MSN, APRN, ACNS-BC, CEN
Present Position: Baptist Health Paducah
Type of Position: Nursing and Institutional
Research Coordinator
Area of Expertise: Clinical Specialist and
Researher
Education:
University
of
Kentucky,
PhD
candidate; Murray State University BSN, MSN
Statement: The nursing profession is my passion
and being elected to a position with KNA would
provide me the opportunity for professional and
personal growth. I am a nurse and patient advocate
to the extreme and this position would empower
me to promote high standards in nursing practice,
nursing education, and nursing services. The
Kentucky Nurse Association has always encouraged
innovation,
empowerment,
and
professional
development and it would be an honor to be part of
this association.
EDUCATION ROLE (vote for 1)
Sonia Rudolph, MSN, APRN, FNP-BC
Present Position: Jefferson Community and
Technical College
Type of Position: Faculty
Area of Expertise: Educator, Nurse Practitioner
Education: Jefferson Community College, AASNursing; Spalding University, BSN, MSN-FNP
Professional Organizational Activities: KNA
Governmental Affairs Cabinet
The Human Touch
the painting
“The Human Touch” is an
original oil painting 12” x 16”
on canvas which was the titled
painting of Marge’s first art
exhibit honoring colleagues
in nursing. Prompted by
many requests from nurses
and others, she published a
limited edition of full color
prints. These may be obtained
from the Kentucky Nurses
Association.
Marsha D. Woodall, MBA, MSN, RN
Present Position: KCTCSMadisonv i l le Com mun it y
College
Type of Position: Nurse
A d m i n i s t r a t o r, P r o g r a m
Coordinator
A rea of Expertise:
Educational Administrator
E d u c a t i o n : E a s t e r n
K e n t u c k y U n i v e r s i t y,
ENROLLED
in
Doctor
of
Nursing
Practice
in
Organizational Leadership – expected graduation
May, 2016; University of Southern Indiana Master
of Science in Nursing Management and Leadership;
National University in San Diego Master of Business
Administration in Health Care Administration;
Murray State University, Bachelor of Science in
Nursing
Professional Organizational Activities: District
11 President; Professional Nursing Practice &
Advocacy Cabinet
Statement: I would like to be considered for the
position of Administrative Role on the Professional
Nursing Practice & Advocacy Cabinet. I have
served the past two years on this cabinet in the
education role and feel that this has prepared me
for the administrative role. My experience and
education have allowed me to see the importance
of nursing education in various settings. Educators
need to prepare students to become nurses who
can positively impact health outcomes. I believe
in promoting evidence-based practice for nursing.
I hope that by my serving on the committee I can
influence and advocate for the future of nursing.
KENTUCKY NURSES FOUNDATION (KNF) BOARD
OF TRUSTEES
The KNF is in a re-building stage and has
suspended formal elections while re-organizing.
However, write in nominations for the KNF Board
of Trustees are most welcome if you or someone
you know has an interest in fundraising and
promotion of scholarships for nursing education
and research.
The Human Touch
Her step is heavy
Her spirit is high
Her gait is slow
Her breath is quick
Her stature is small
Her heart is big.
She is an old woman
At the end of her life
She needs support and strength
From another.
The other woman offers her hand
She supports her arm
She walks at her pace
She listens intently
She looks at her face.
She is a young woman at the
Beginning of her life,
But she is already an expert
in caring.
RN Poet
Beckie Stewart*
*I wrote this poem to describe the
painting, The Human Touch
by Marge.”
Edmonds, Washington 1994
Copyright 1980 | Limited Edition Prints by Marjorie Glaser Bindner RN Artist
Limited Edition Full Color Print | Overall size 14 x 18 | Signed and numbered (750)—SOLD OUT
Signed Only (1,250)—$20.00 | Note Cards—5 per package for $6.50
for mail or fax orders
I would like to order an art print of “The Human Touch”©
______ Signed Prints @ $20.00
_____________ Total Purchases
______ Package of Note Cards @ 5 for $6.50
_____________ Shipping & Handling (See Chart)
______ Framed Signed Print @ $180.00
_____________ Subtotal
_____ Gold Frame
Kentucky Residents Add 6% Kentucky Sales Tax
_____ Cherry Wood FrameTax Exempt Organizations Must List Exempt Number
______________TOTAL ________________________________________
Make check payable to and send order to: Kentucky Nurses Association, P.O. Box 2616, Louisville, KY 40201-2616
or fax order with credit card payment information to (502) 637-8236 or email to [email protected].
Name:____________________________________________________ Phone:_____________________________
Address:____________________________________________________________________________________
City: ______________________________________________ State_______________ Zip Code:_______________
Visa/MasterCard/American Express/Discover:_________________________________________________________
Expiration Date:______________________________________________________________ CIV: ____________
Signature (Required): ____________________________________________________________________________
Shipping and Handling
$ 0.01 to $ 30.00. . . . . . . . . . . $6.50
$ 30.01 to $ 60.00 . . . . . . . $10.95
$ 60.01 to $200.00 . . . . . . . $30.00
$200.01 and up. . . . . . . . . . $45.00
*Express delivery will be charged at
cost and will be charged to a credit
card after the shipment is sent.
Page 14 • Kentucky Nurse
July, August, September 2015
Cultural Diversity
Costa Rica Mission Trip
Heather Lenz, BSN Student
Mollie E. Moss, BSN Student
Paige Owens, BSN Student
Sophia Proctor, BSN Student
Sarah Slone, BSN Student
Mentor: Sharon Edwards, DNP, APRN
Eastern Kentucky University
Richmond, Kentucky
The need to not only recognize but also incorporate cultural diversity is
paramount with the diversity of nursing care expanding. Jones, Ivanov, Wallace,
and VonCannon (2010) reported that student experiences in a developing
country enhanced their cultural sensitivity in providing care to individuals
from different cultures in the United States. Atkins and Stone (2006) related
a similar result with their students in Honduras; the students identified the
transcultural experience to be “life changing” and enhanced their cultural
sensitivity (p. 150). In order to facilitate the understanding of cultural diversity,
an immersion project was provided for a group of five baccalaureate nursing
students through a cultural diversity class offered in the winter term at Eastern
Kentucky University. The
educational opportunity
was with a medical
missionary
group
to
Costa Rica.
Overview of Costa Rica
Costa Rica gained
independence from
Spain in 1821 and
had to develop its own
healthcare system
(Geist-Martin & Bell,
2 0 0 9 ) . P r e v i o u s l y ,
Costa Ricans relied on
curanderos,
shamans,
and
spiritists
whose
practices were based on
herbal remedies, magic,
and faith (Geist-Martin
& Bell, 2009). Costa Rica
currently has a universal
healthcare system which
is run by a government
institution called the
Caja (Boddiger, 2012).
The recent budget cuts
in healthcare require
many
health
care
providers to care for
double the amount of
patients which caused
as many as 850 patients
a month a delay in receiving healthcare and increased patient waiting room
times to an average of seven hours; thus diminishing many services available to
patients (Boddiger, 2012).
Costa Rican providers communicate in ways that are both authenticating
and integrating, to provide holistic care for patients that emphasize the values
of building and maintaining relationships (Geist-Martin & Bell, 2009). These
two practices of communicating highlight such traits as listening, incorporating
the words of the patient, and empathizing with them. They also emphasize
the importance of legitimizing the patient’s authority and understanding that
humans are “whole” organisms composed of many parts and shaped by many
things (Geist-Martin & Bell, 2009). According to Geist-Martin and Bell (2009),
the Costa Rican healthcare providers found importance in recognizing that
July, August, September 2015
Kentucky Nurse • Page 15
Cultural Diversity
healing is progressive and does not occur overnight,
but can occur over one’s lifetime.
Recent Health Care Issues in Costa Rica
Lifestyle-related diseases such as hypertension
and type two diabetes are the leading causes of
death and disability, and represent a large cost
to health care systems in Central America (Fort,
Alvarado-Molina, Peña, Mendoza, Murrillo, &
Martínez, 2013). Proper management of these
illnesses is not only pharmaceutical, but includes
lifestyle changes by the patients (Fort et al., 2013).
Two major factors in chronic disease management
are the patient’s perception of his or her disease and
effective communication between the patient and
health care providers (Fort et al., 2013). According
to the study results of Fort, et al. (2013), the major
barriers to self-management of diseases included:
not accepting the disease, lack of information
about symptoms, vertical communication between
providers and patients, difficulty negotiating
commitments, perception of healthy food as
expensive or unsatisfying, difficulty adhering to
lifestyle changes, other health anomalies, and health
care becoming monotonous.
Between January and July 2009, poor standard
infection control precautions in Costa Rican
hospitals lead to a major infection outbreak, such as
a severe Clostridium difficile BI/NAP1 outbreak in a
Costa Rican General Hospital (Wong-McClure et al.
2013, p. 914). A study was conducted to determine
the effect of the C. difficile outbreak on the control
practices implemented and the determining factors
associated with the outbreak (Wong-McClure et
al., 2013). The results confirmed that the infection
control measures used were effective in controlling
the C. difficile BI/NAP1 outbreak (Wong-McClure et
al., 2013).
Cultural Experience
The medical missionary clinics were held in a
local school just outside of San Jose, the capital city
of Costa Rica. The purpose of the medical mission
was to provide health care for those that do not
otherwise have access to regular health screenings
or a primary care provider. In the clinic, physicians
were able to use assessment skills to diagnose and
treat the patient appropriately. The nursing students
took heart rate, blood pressure, temperature,
respiratory rate, and oxygen saturation before the
patient went to see the doctor. These values were
written on a piece of paper and the patient carried it
with them throughout their visit. These papers also
had a number on them to indicate which patient or
family was next in line to see the doctor.
In addition to providing fairness to the patients,
the papers helped to establish some form of
organization in somewhat of a chaotic environment.
The location of the clinic presented challenges
such as providing privacy to clients, lack of
running water, and no clear indication of where the
patient should go next after seeing the health care
providers. Medical mission trips require working
with what is available and being as resourceful as
possible. The desks were pushed to the back of the
classroom except for a few to allow for a space for
the equipment such as blood pressure cuffs and
stethoscopes. The classroom chairs were taken into
the outdoor hallway to provide a “waiting room”
for all of the patients awaiting the doctor. Those
working in the clinic involved physicians, nurse
practitioners, nurses, student nurses, and other
personnel such as Spanish interpreters. The patients
would be given their paper with their number on it
before entering the school, directed to a classroom
where vital signs were taken and then directed to
the hallway to wait to see the doctor. After seeing
the doctor, they were directed to the pharmacy to
get the medication recommended for their treatment.
Education was provided and clarification was
written on a sticker that was applied to the medicine
bottle such as “take one pill with breakfast every
day for four days.” If medications ran out, the health
care providers used alternative methods such as
instructing the patient to use tea and honey to
relieve a sore throat instead of providing them an
antibiotic. If necessary, the patients could also be
evaluated for reading glasses.
While patients were waiting on the doctors,
the children were gathered into a large group for
students to provide an education opportunity. The
children were educated about the dangers and
prevention of burns. A second topic was on hand
hygiene including when and why hand washing
is so important. The learning opportunities were
supported by reading a book to the children and
providing coloring activities pertaining to the
information. In addition to reading and coloring,
the hand hygiene lesson was demonstrated by
showing how fast glitter, which provides a visual
representation of germs, spreads when touching
objects or other people. The children enjoyed these
learning experiences and were able to take their
coloring sheets home as a reminder of what they
learned.
Summary of Student Experiences and
Lessons Learned
Although the experience was different for everyone
who participated in this mission trip, each of the
students agreed that it provided an opportunity
for not only personal growth, but improvement in
nursing skills. Nursing skills are more inclusive
than administering medications and taking vital
signs and includes treating patients with respect
and viewing them as not just a client, but a human
being. The importance of understanding simple
differences between people became evident as
well; recognizing that each person has a different
life experience, whether it be because of race or
socioeconomic status, is essential to providing
holistic nursing care. Each of the nursing students,
as well as others on the trip, admitted that it had
been a life changing experience for them. It was
agreed that being immersed in a different culture
and providing care for these people was above
all a challenging experience, but worth every
penny and second spent. Not only was the group
immersed in a culture with a different language
and health care system, but a different way of life
with extreme circumstances of poverty. Nursing
care and education had to be hugely modified to fit
this particular group of people and the resources
available.
The take home lesson from this medical mission
trip from a nursing stand point would be to always
be flexible. Providing culturally competent nursing
care is not possible for a closed mind. Holistic
nursing includes the physical, emotional, mental,
and spiritual aspects of each different patient; there
is no way to address all of these aspects without
taking culture into consideration. In the unanimous
opinion of the five nursing students who attended
this medical mission trip, a cultural immersion
experience is invaluable to becoming competent
and caring nurses as well as promoting personal
development.
References
Atkins, M. & Stone, K. S. (2006). Undergraduate and
graduate students partnering in a short term
transcultural experience in Honduras. The ABNF
Journal Fall 2006. 147-151. Retrieved from: http://
libprox y.eku.edu/login?url=http://search.ebscohost.
com/login.aspx?direct=true&db=a9h&AN=232950638&
site=ehost-live&scope=site
Boddiger, D. (2012). Costa Rica restructures health system
to curb financial crisis. Lancet, 379(9819), 883.
Fort, M. P., Alvarado-Molina, N., Peña, L., Mendoza
Montano, C., Murrillo, S., & Martínez, H. (2013).
Barriers and facilitating factors for disease selfmanagement: a qualitative analysis of perceptions
of patients receiving care for type 2 diabetes and/
or hypertension in San José, Costa Rica and Tuxtla
Gutiérrez, Mexico. BMC Family Practice, 14(1), 131-139.
doi:10.1186/1471-2296-14-131
Geist-Martin, P., & Bell, K. K. (2009). “Open Your Heart
First of All:” Perspectives of Holistic Providers in
Costa Rica About Communication in the Provision of
Health Care. Health Communication, 24(7), 631-646.
doi:10.1080/10410230903242234
Jones, E. D., Ivanov, L. L., Wallace, Debra. &
VonCannon, L. (2010). Global service learning project
influences culturally sensitive care. Home Health
Care Management & Practice, 22 (7), 464-469. doi:
10.1177/1084822310368657
Sharman, C. H. (2005). Improving mental-health care in
Costa Rica. Lancet, 366(9480), 111-112. doi:10.1016/
S0140-6736(05)66849-3
Wong-McClure, R. A., Ramírez-Salas, E., Mora-Brenes, N.,
Aguero-Sandí, L., Morera-Sigler, M., Badilla-Vargas,
X., & ... Bryce, E. (2013). Long term effect of infection
control practices and associated factors during a major
Clostridium difficile outbreak in Costa Rica. Journal
of Infection in Developing Countries, 7(12), 914-921.
doi:10.3855/jidc.2854
KNA Centennial Video
Lest We Forget Kentucky’s
POW Nurses
This 45-minute video documentary is a KNA
Centennial Program Planning Committee
project and was premiered and applauded
at the KNA 2005 Convention. “During the
celebration of 100 years of nursing in Kentucky—
Not To Remember The Four Army Nurses From
Kentucky Who Were Japanese prisoners for 33
months in World War II, would be a tragedy.
Their story is inspirational and it is hoped that it
will be shown widespread in all districts and in
schools throughout Kentucky.
POW NURSES
Earleen Allen Frances, Bardwell
Mary Jo Oberst, Owensboro
Sallie Phillips Durrett, Louisville
Edith Shacklette, Cedarflat
____ Video Price: $25.00 Each
____ DVD Price: $25.00 Each
____ Total Payment
Name__________________________________________
Address________________________________________
City____________________________________________
State, Zip Code ________________________________
Phone _________________________________________
Visa * MasterCard * Discover * American Express
Credit Card # __________________________________
Expiration__________________ CIV: _____________
Signature______________________________________
(Required)
Kentucky Nurses Association
P.O. Box 2616
Louisville, KY 40201-2616
Phone: (502) 637-2546 Fax: (502) 637-8236
Email: [email protected]
Page 16 • Kentucky Nurse
July, August, September 2015
Chapter News
“NURSING: LIGHT OF HOPE”
by
Scott Gilbertson
Folio Studio, Louisville, Kentucky
Highlighted Chapter of the Month:
Kentucky Nurses REACH
In a new feature article, the Kentucky Nurse publication will feature one of
the KNA chapters in each edition. We look forward to hearing more about what
Kentucky Nurses are doing in each chapter. Please contact Maureen Keenan to see
about submitting information for your chapter in an upcoming edition.
Kentucky Nurses REACH (Research, Educate, Advocate, Care and Help)
Chapter, formerly District 7, is based in southcentral Kentucky. The group
has a wide range of members from across the southcentral region of the state.
Currently the membership stands at approximately 75 nurses and the group
invites others to join.
Current officers are Kim Bourne, chairperson; Dawn Garrett-Wright,
secretary; and Anne Afton, treasurer. These nurse leaders plan activities for
Kentucky nurses throughout the year and disseminate information to members
of the chapter. Activities for the 2014-2015 year have included the following:
On October 9, 2014, some of the REACH members who attended the KNA
Convention at Louisville had dinner together at the Olive Garden. Several
members attended the poster session at the Convention and REACH nurses
were well-represented among the presenters at the session.
On November 18, 2014, the chapter met at Greenview Regional Hospital, in
Bowling Green. Dr. Beverley Holland presented information related to healthcare
in Ecuador and shared experiences from her trip to that country. Students from
two schools of nursing attended this meeting. CEs were awarded to attendees.
On February 3, 2015, nurses from TJ Samson Hospital hosted the meeting at
the TJS Health Pavilion. Leslie Bradshaw was the guest speaker and presented
research associated with the expanded use of lift devices entitled “Safe Patient
Handling.” CEs were awarded to attendees. Those present elected to participate
in a project to collect items for emergency medical services to distribute to
children in crisis and voted to also gather similar items for children in foster
care. Again, there was student representation from two schools of nursing.
The annual joint meeting of the Kappa Theta chapter of Sigma Theta Tau
and the REACH chapter of KNA convened at the Bowling Green Medical Center
Health Science Complex, on April 14. Members reviewed poster presentations
and oral presentations of research projects from community nurses and nursing
students. Nurses from across the state were invited to attend this presentation.
For more information, please contact Kim Bourne at [email protected].
Photo submitted by the Kentucky Nurses Association, July
2005 to the Citizens Stamp Advisory Committee requesting
that a first class stamp be issued honoring the nursing
profession. (Request Pending)
Package of 5 Note Cards with Envelopes - 5 for $6.50
I would like to order “Nursing: Light of Hope” Note Cards
_______
_______
_______
_______
_______
Package of Note Cards @ 5 For $6.50
Shipping and Handling (See Chart)
Subtotal
Kentucky Residents Add 6% Kentucky Sales Tax
TOTAL
Make check payable to and send order to: Kentucky Nurses Association, P.O. Box
2616, Louisville, KY 40201-2616 or fax order with credit card payment information
to (502) 637-8236 or email to [email protected]. For more
information, please call (502) 637-2546.
Name:________________________________________ Phone: ______________________
Address: ___________________________________________________________________
City: _________________________________State: _______Zip Code: ______________
Visa/Master Card/Discover/American Express: _____________________________
Expiration Date:___________________ CIV: ________________
Signature (Required for Credit Card Orders):____________________________________
Shipping and Handling
$0.01 - $30.00…...$6.50
$60.01 - $200.00……$30.00
$30.01 - $60.00…..$10.95
$200.01 and up…...…$45.00
*Express Delivery will be charged at cost and will be charged to a credit card after
the shipment is sent.
Credit Card: __ Visa __ MasterCard __ Discover __ American Express
Number: __________________________ Exp. Date: ________ CIV: ______
July, August, September 2015
Kentucky Nurse • Page 17
Nurses on the Move
Introduce 10 RN Friends
and Colleagues to
KNA-ANA Membership and
You’ll Earn a $25 Amazon
Gift Card!
Ready, set, go — KNA and ANA’s Member-Geta-Member program is here! Start referring your RN
friends and colleagues for KNA-ANA membership.
You’ll earn a free ANA webinar and a $25 Amazon
gift card. Refer more RNs; you could earn two or
even three $25 Amazon gift cards. It’s a win/win for
you, your friends and the nursing profession.
It’s easy to be a Volunteer Recruiter. There is no
commitment, no quotas and absolutely no selling.
You can participate as much as you like. Here’s how:
1.Get your Volunteer Recruiter Toolkit at
www.nursingworld.org/MGM-KNA. You’ll find
everything you need to get started including:
•
•
•
•
•
Frequently asked questions
Recruitment tips
Finding future members
KNA-ANA member benefits flyer
Sample email you can share with your
colleagues
2.Go online (www.nursingworld.com/MGM-KNA)
and provide KNA with the name and valid email
addresses of your coworkers, nursing school
chums, neighbors — every RN you know who
should join. You can enter one name and
email address today, another tomorrow and
even more next week. We’ll keep track and
send you rewards as you’ve earned them!
3.That’s it. All you have to provide is the contact
information. Once you enter the names and
valid email addresses online — we’ll take it
from there!
You’ll be sharing the benefits of local and national
membership. Benefits that advance careers, patient
care and the profession.
Not sure whether a nurse is already a member?
No problem. We’ll verify their membership status —
and reach out if they are not one.
Plus, you’ll be richly rewarded for your efforts. As
a Volunteer Recruiter you will earn:
• A free Stepping into Your Spotlight:
Building Your Professional Brand webinar
when you submit 9 or fewer names and
email addresses of future members. This
eye-opening presentation will show you how
creating, developing and promoting your
personal brand as a nurse can truly set you
apart.
• A $25 Amazon gift card for every 10 future
member names and email addresses that you
provide. Supply 10 emails and names; you’ll
receive one $25 Amazon gift card. Supply 10
more and you’ll receive another $25 Amazon
gift card.
• Special recognition on the KNA website
We hope you enjoy sharing the value you receive
as a member – letting colleagues know about KNA
and ANA’s efforts to support nurses’ scope of practice
or a timely article you read in American Nurse Today.
This is a great opportunity for you to help KNA
and ANA grow. Every nurse should have professional
development resources that will help them meet
today’s ever-changing practice and career needs.
And when we speak for nurses, in Frankfort or
Washington, we want to speak out on behalf of every
nurse in Kentucky.
Get Started today at www.nursingworld.org/
MGM-KNA
Questions? Contact [email protected].
Eva Stone
Eva Stone, a KNA member, and school nurse
champion, was awarded the School Nurse
Leadership Award May 2015. She is currently the
Coordinator of School Health for Lincoln County,
but is also active in the Kentucky Coalition of Nurse
Practitioners / Nurse Midwives (Regional Director),
chairs the School Health Section Kentucky Public
Health Association, is on the Community Advisory
Committee Foundation for a Healthy Kentucky, a
Member of Kentucky Youth Advocates Children’s
Health Taskforce, and a member of Friedell
Committee for Health System Transformation. Eva
presented at the KNA Summit Social Determinants
of Health in October 2013, at which time several
KNA members started conversations with her about
the School Nurse Initiative. With Eva’s inspiration,
KNA immediately started planning strategies to
ensure that all Kentucky public schools would have
school nurses. Eva gave KNA the names of major
stakeholders (Karen Erwin, Sandi Clark, Pat Glass),
major interest groups (Friedell, KY Youth Advocates),
very dedicated school health nurses (who have been
actively involved in the KNA initiative since Jan
2014), and got the KNA School Nurse workgroup
enrolled on the Kentucky School Nurse Website.
Ultimately Eva helped develop and then analyzed
the data of a school nurse survey that provided
the School Nurse work group with invaluable
information related to the state of school nurses
in Kentucky. Every time KNA has had a question
related to school nursing, how it is funded, how data
is mined, she has referred KNA to the right sources.
She was instrumental in guiding a KNA / doctoral
nursing student and board member, through a
very well defined project to determine the benefit
of the school nurse, as that school nurse affects
attendance, ACT scores, and graduation rates.
Eva is truly a champion for kids! According to her
supervisor in Lincoln County, Karen Hatter, “Eva
has a zeal for her work that keeps her performing at
the top ranks for her peers...a leader that possesses
a clear vision for a better future.”
Vibrant Louisiana
Community!
Up to $10,500
Relo/Sign-on Bonus
sLargest Health Care System in
LA need your skills!
sImmediate Full-Time Position
Openings...Most Specialties
sLimited New Graduates
Welcome sSafe Patient Ratios/Caring
Nurse Mgrs.
sDay Shifts available /
Exceptional Benefits
sEnjoy your profession…
reach your potential!
Barbara Hawkins received the 2015 Workplace
Health
and
Safety
Stewardship
Award
at
the
American
Association
of
Occupational
Health Nurses (AAOHN) Conference in Boston,
Massachusetts, on March 25, 2015. Sponsored by
UL and AAOHN, the annual award acknowledges an
unsung nursing hero who is dedicated to creating a
culture of health and safety in the workplace.
Barbara retired in 2014 from LG&E-KU as
Manager of Corporate Health and Safety, responsible
for all corporate health, safety, and wellness
programs and initiatives.
You’ve earned your
dream job.
ATTENTION ALL RN
Professionals!
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Contact Jim Cox
1-800-304-3095 Ext 105,
email [email protected]
Cell 210-885-5483, eves ok,
can text as well
RN - BSN Online
Contact Dr. Carol Murch, [email protected]
BSN
Contact the School of Nursing, 270.809.2193
Advanced Practice DNP Options:
• Family Nurse Practitioner
• Nurse Anesthesia
• Post-Master’s DNP Program
For more information contact:
Dina Byers, Ph.D., APRN, ACNS-BC
[email protected]
270.809.6223
Providence Pavilion has openings for
RNs, LPNs and KMAs
For information on career opportunities contact
Peggy Rowekamp, HR Director at
859-283-6635 | [email protected]
401 E. 20th Street | Covington, KY 41014
www.providencenky.com
nMore than 15 years experience in educating advanced practice
nurses to meet the complex health care needs of society.
nStrong faculty committed to excellence in education
and practice.
School of Nursing
www.murraystate.edu/nursing
Equal education and employment opportunities M/F/D, AA employer
Page 18 • Kentucky Nurse
July, August, September 2015
Poetry Corner
The Last Trip
A Simple Sweet
Death Poem
By M. L. Jordan
It came his time;
My heart seems to ache more as I grow older.
such a beautiful death,
lying between his two daughters
Serious, sharp, intense little stabs that jolt me out of
my tiredness,
he drew his last breath.
Which also is a problem – being so tired all the time,
No fear from death’s coming;
As I rush headlong into my seventh decade.
The body bag, and the transport to the temporary
morgue down in the hospital basement,
No regrets from his lips.
It makes me worry, but every time I have a test, an
Echo, labs, stress test
Unless the funeral home can come pick you up
right away.
Everything comes back negative, essentially.
You have about a 50/50 shot at that by the way if
you die in the hospital, if it’s a large hospital.
Not one word was spoken
he was waiting for this.
As the moment approached,
he embraced both their hands,
a final act of sharing in the life he had spanned.
He smiled at them knowingly;
They shed not a tear
But looked upon him lovingly
as his death drew near.
He took in the last breath;
As I also held mine,
The daughters smiled at him sweetly as he left
them behind.
As life lifted off him, his spirit so sweet
that Heaven, that instant, I knew his soul
was to meet.
That gentle, loving father, two daughters behind;
My lipids are high, no surprise.
I’m overweight, not by much, but have mild
hypertension. I wear readers. The usual.
But it’s not the physical pain of my heart hurting
that worries me.
It’s the heartache of the reality settling in that my
days are numbered, so to speak.
Why, when I was younger, did I not appreciate aging,
take it more seriously?
Respect that it was out there waiting for the day it
arrived to greet me saying,
“Well, I know you’ve been expecting me, sorry it took
me so long to get here,
But I’m here and I’m here to stay.”
Where is the beautiful young face that is covered up
by this sagging reflection?
And the thin, fine boned, beautiful body and
long hair?
a simple sweet death that often crosses my mind.
It’s like I was never her. She was an illusion. I would
always be older a lot longer than I would be young.
~Rhonda G. Vale
Why didn’t I know that?
Why doesn’t anyone tell you that?
Dynamic Career Opportunity
Mildred Mitchell-Bateman Hospital is a 110-bed acute care mental
health facility operated by the West Virginia Department of Health and
Human Resources. We are seeking qualified staff to fill permanent
and temporary positions.
• RNs • LPNs • Health Service Workers (CNA)
• Interpreters for the Deaf
Some of the benefits you will enjoy:
• Paid holidays with incentive for working Thanksgiving, Christmas,
and New Year’s Day
• Accrued sick leave
• Accrued annual leave
• Shift differential for evenings and night shifts
• Education assistance (tuition reimbursement)
• Annual increment pay after 3 years of service
• Public Employees Retirement System
• Comprehensive health insurance plans, including PEIA
• Prescription drug plan and optional dental and vision coverage
• Staff to acuity
Temporary positions do not include benefits.
Interested individuals should contact:
Patricia G. Hamilton, RN BC Chief Nurse Executive
[email protected]
1530 Norway Avenue,
Huntington, WV 25709
Phone: 304-525-7801 x 734
Fax: 304-529-6399
www.batemanhospital.org
Mildred Mitchell-Bateman Hospital is a Drug Free Workplace.
Minorities are encouraged to apply. Equal Opportunity Employer.
To be written on the line where it asks: Name: Then
there’s a place for date of birth,
Then Date of Death:
I’ve filled out hundreds of them as a Hospice Nurse. I
know what’s coming.
And, here’s what else I know: the people, a nurse or
a tech, who takes you down to the morgue
Come in one of two varieties: the ones who love to
take you to the morgue
Because they are looking for a quick smoke break or
need to use their cell and your death
Has provided them with that opportunity, and who,
by the way, don’t care about the dead person,
One way or the other, being jostled inside that black
bag, goin’ fast, telling jokes and talkin’ trash.
Then there’s the other person who hates taking you
to the morgue because it’s sad.
They’re feeling the weight of the families’ sorrow,
And your exposure to unseemly things that await
you at the hands of the mortician.
They may worry about your soul, if you were saved.
Or don’t care about that, but still are saddened by
death, in a way that a sensitive person would be.
They always take you down to the morgue gently, are
usually silent,
Sometimes murmuring a prayer over your body,
Or have they been saying it all along and, like the
young, they don’t listen. I didn’t listen.
Gently sliding you into the refrigerated bin with a
sense of their mortality.
So, I’m preparing myself to say goodbye. I will be
happy enough I suspect.
They recognize it as very special moment. They feel
honored to be with you at this important time.
Who wants to be ugly and feel pains in their heart?
I hope for you that this is the person who takes your
body and cleans it.
And the physical jolts I experience are reminders of
the day that’s out there with
My name hovering above the form that is my Death
Certificate, not quite ready
And yes, maddeningly, puts the tag on your toe as
they must.
And wipes away whatever needs to be cleaned with
loving hands.
Carmel Manor
Eyes never roving over your body – because after all
it is still your body – still your dignity.
“Six Decades of Loving Care!!!”
We offer Personal, Skilled Care and Rehab Services
I hope this is the person who accompanies you.
Because I have been her.
Located just outside of Cincinnati—we have a beautiful location
overlooking the Ohio River.
Serving the Northern Kentucky/greater Cincinnati area.
Carmel Manor is a 145-bed nursing facility—looking for RNs
for a “long term” commitment.
Schedule a visit with us—you will feel the difference!!
Carmel Manor Rd. 859-781-5111
Ft. Thomas, KY
Department of
Nursing Faculty
The College of Health Professions is seeking applications for a full-time,
tenure-track, faculty position in the Department of Advanced Nursing
Studies. Faculty responsibilities also include teaching, service, scholarship, and
academic advising. Teaching assignments may be in the RN-BSN, MSN, and/
or DNP programs. MSN required (with future commitment for doctoral study);
Doctorate preferred; Credentialed as Nurse Practitioner is a plus; Candidates
should have strong teaching experience in nursing, preferably at the graduate
level; Online teaching experience or interest is needed; Minimal qualifications
include two (2) years of experience in nursing education at the collegiate level
within the last 5 years; Must possess a valid nursing license through the
Kentucky Board of Nursing or be eligible for licensure.
Visit http://jobs.nku.edu:80/postings/2373 for more details.
Maintaining Oral Health in
the Primary Care Setting
(First in a Series)
An inter-Professional Education and Collaboration Course
for the Advanced Practice Nurse and Dental Hygienist.
This course includes approaches to optimizing oral health
and summarizes the importance of the U.S. Preventative
Services Task Force (USPSTF). Approved by Kentucky Board
of Nursing.
Event Date: Friday, September 25, 2015
Location: U of L Shelby Campus - Founders Building
Lecture: CEU(s) - 3
Education Method: Live Interactive Format
For more information and on-line registration, please visit our
website @ www.louisville.edu/dental/continuingeducation
July, August, September 2015
Kentucky Nurses Association
Calendar Of Events 2015
July 2015
23-25 2015 ANA Membership Assembly, Renissance Washington
Downtown, Washington DC
August 2015
1
KNA Ballot 2015 Mailing
10
Deadline for the Kentucky Nurse (October/November/December
2015 Issue)
28
10:30 AM – 5:00 PM Kentucky Board of Nursing Meeting
September 2015
7
Labor Day Holiday – KNA Office Closed
October 2015
2
Education Summit, Embassy Suites, 1801 Newtown Pike,
Lexington, Kentucky 40511. Overnight Reservation - 859-4555000
2-4
7-10
14
11
Membership Activation Form
For dues rates and other information, contact ANA’s Membership Billing Department at (800) 923-7709
or e-mail us at [email protected]
Essential Information
First Name/MI/Last Name
Gender: Male/Female
Mailing Address Line 1
Credentials
Mailing Address Line 2
Phone Number
City/State/Zip
Email Address
Professional Information
Employer
Current Employer Status: (ie: full-time nurse)
Type of Work Setting: (ie: hospital)
Current Position Title: (ie: full-time nurse)
Practice Area: (ie: pediatrics)
Ways to Join
✓ ANA and State Membership Dues:
$15.00 Monthly or $174.00 Annual
ANA-PACContribution (optional).................. $
ANCC National Magnet Conference, Atlanta, GA
Total Dues and Contributions ........................ $
10:30 AM – 5:00 PM Kentucky Board of Nursing Meeting
Credit Card Information
Visa
Mastercard
AMEX
Deadline for the Kentucky Nurse (January/February/March
2016 Issue)
Veterans Day - KNA Office Closed
26-27 Thanksgiving Holiday – KNA Office Closed
December 2015
11
10:30 AM – 5:00 PM Kentucky Board of Nursing Meeting
21-31 Christmas Holiday – KNA Office Closed
Circle preference: Home/Work
Country
Kentucky Association of Nursing Students (KANS) Annual
Conference, Embassy Suites, 1801 Newtown Pike, Lexington,
Kentucky 40511 Overnight Reservation - 859-455-5000
November 2015
5-8
National Student Nurses Association (NSNA) Mid-Year
Conference, Atlanta, Georgia
9
Kentucky Nurse • Page 19
Membership Dues
ANF Contribution (optional)........................... $
Credit Card Number
Discover
Expiration Date (MM/YY)
Required: What is your primary role in nursing
(position description)?
Clinical Nurse/Staff Nurse
Nurse Manager/Nurse Executive (including Director/CNO)
Nurse Educator or Professor
Not currently working in nursing
Advanced Practice Registered Nurse (NP, CNS, CRNA)
Other nursing position
Ways to Pay
Monthly Payment: $15.00
Check
If paying by credit card, would you
Credit Card like us to auto bill you annually?
Yes
Annual Payment: $174.00
Checking Account Attach check for first month’s payment.
Credit Card
Authorization Signature
Authorization Signatures
Printed Name
Monthly Electronic Deduction | Payment Authorization Signature*
Please Note — $20 of your membership dues is for a subscription to
The American Nurse and $27 is for a subscription to American Nurse Today.
American Nurses Association (ANA) membership dues are not deductible
as charitable contributions for tax purposes, but may be deductible as a
business expense. However, the percentage of dues used for lobbying by
the ANA is not deductible as a business expense and changes each year.
Please check with ANA for the correct amount.
Automatic Annual Credit Card | Payment Authorization Signature*
Go to JoinANA.org to become
a member and use the code:
ADKNA15
*By signing the Monthly Electronic Payment Deduction Authorization, or
the Automatic Annual Credit Card Payment Authorization, you are
authorizing ANA to change the amount by giving the above signed thirty
(30) days advance written notice. Above signed may cancel this
authorization upon receipt by ANA of written notification of termination
twenty (20) days prior to deduction date designated above. Membership
will continue unless this notification is received. ANA will charge a $5 fee for
any returned drafts or chargebacks. Full and Direct members must have
been a member for six consecutive months or pay the full annual dues to be
eligible for the ANCC certification discounts.
Fax
Web
Mail
Completed application with credit card
payment to (301) 628-5355
Join instantly online.
Visit us at JoinANA.org
ANA Customer & Member
Billing PO Box 504345 | St. Louis, MO 63150-4345
*All members are invited to attend KNA Board of Directors meetings
(please call KNA first to assure seating, meeting location, time and date)
www.nursingALD.com
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Page 20 • Kentucky Nurse
July, August, September 2015
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