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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 Permit #14 Princeton, MN 55371 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. www.frontier.edu/KYnurse 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 KNA’s limited edition was published in 2006. Graphics by Folio Studio, Louisville and printing by Merrick Printing Company, Louisville. Gratitude is expressed to Donors whose names will appear in the book’s list of Contributors. Their gifts have enabled us to offer this limited edition hard-back coffee-table-type book at Below Publication Cost for Advance Purchase Orders. The Editors have collected pictures, documents, articles, and stories of nurses, nursing schools, hospitals, and health agencies to tell the story of Professional Nursing in Kentucky from 1906 to the present. Special Price - $18.87 Per Book ___ $18.87 per book ___ $1.13 sales tax per book ___ Add $6.50 shipping and handling per book ___ (for 1-5 books - $10 or 6-19 books $20) ___ Total Purchase ___ Grand Total Name _________________________________________________ Address _______________________________________________ City__________________________________________ State____________________________ Zip__________ Credit Card Payment (Circle One): MasterCard – Visa – Discover - American Express Number _______________________________________________ Exp. Date ____________________________________ CIV___________________________________________ Signature _____________________________________________ Fax, Mail or E-mail Order to: Kentucky Nurses Association P.O. Box 2616, Louisville, KY 40201-2616 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! Join one of the “Top Rated Hospitals in the Nation” Kentucky Nurse Recognized for Workplace Health and Safety We’ll help you find it at nursingALD.com Your free online resource for nursing jobs, research, & events. 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 Searching for your dream job? We can help. Page 20 • Kentucky Nurse July, August, September 2015 SimpleWreath specializes in handmade, natural looking wreaths that enhance the beauty of your home, both inside and out. Etsy: http://www.etsy.com/shop/ simplewreath Facebook: https://www.facebook.com/simplewreath E-mail: [email protected] I would love to have you visit my shop! If you have questions or would like to request a custom order, please do not hesitate to contact me. New! Now offering monograms! SimpleWreath Please enjoy 10% off with coupon code: NURSE10