ANA Maine Journal - May 2014

Quarterly circulation approximately 22,000 to all RNs, LPNs, and Student Nurses in Maine.
Maine Lupins
Photo courtesy of
Juliana J. L’Heureux
Journal Highlights
SPRING 2014
Save the Date!!!
September 27, 2014
It’s a Birthday Party and You’re Invited!!!
Page 3
Susan Henderson and Margaret Hourigan
Joint Resolution Recognizing the
Centennial of Maine Nursing
Page 4
State Senator
Emily Cain for Congress
Page 15
President’s Message
Let’s Celebrate!
by Irene Eaton
Sing, skip, stretch out your
arms and twirl! We made
it through that challenging
winter and chilly start to
spring. Enjoy the summer
skies and gentle evenings.
Grab each moment as a gift.
While you experience the
spring into summer, also take
a few moments to check our
new ANA-Maine website and
Irene Eaton
browse through the important
events of September 26 and 27, 2014 planned at two
locations, thanks to interactive technology support! Ann
Napier, Chairperson of the planning committee, provided
a vision for expanding the meeting state wide. Thanks
to her diligent work with the Program Committee’s
support, they created a Birthday Party and program
celebrating a 100 year partnership with ANA, along with
an early celebration of the Maine State Board of Nursing’s
Centennial, next year!
Begin the event at a Friday evening, September 26
membership-only reception in Portland for the newly
elected ANA-President; concurrently, members from
the north-central region are invited to a reception for
Past President Mary Foley. Yes, the birthday celebration,
conference, luncheon with awards and annual meeting
will be at two sites with link by teleconference. We’re
“walking our talk” in efforts to shorten travel distance
and facilitate member participation. The keynote speaker
at the Portland site with the featured speaker at the
UMO site will be concurrent sessions; each site will also
feature local speakers. This is only the tip of the iceberg.
Our compliments and profound gratitude to Ann Napier
and her team, inclusive of Donna Policastro, Executive
Director for this superb program and celebration! See the
Website for details and registration. Please register early!
Recent reports from the American Nurses Association
indicate that at least 50% of the new members joining
are at or under 35 years of age! Awesome! We need you,
your energy, your vision, your in-this-age communication
savvy! Join us in leadership as we develop and expand
ANA’s programs in Maine. Membership dues are only
$13/month. Join now at http://www.anamaine.org/ Attend
our Annual Meeting, Conference and Birthday Party
September 27th. Contact us at info@anamaine.org to
become a part of the action.
Moreover, our ANA-Maine historic centennial Joint
Resolution passed in the Maine Legislature!
Led by Representative Erik Jorgensen of Portland
and Representative Anne Graham of North Yarmouth,
who is our nurse legislator, the Joint Resolution passed
with overwhelming bi-partisan support. In the preamble,
the resolution reads, “Be it RESOLVED: That We,
the Members of the One Hundred and Twenty-sixth
legislature now assembled in the Second Regular Session,
on behalf of the people we represent, that this opportunity
to recognize the 100th Anniversary of nursing practice
and education in the State of Maine; and be it further
RESOLVED: That a suitable copy of this resolution, duly
authenticated by the Secretary of State, be transmitted to
ANA-MAINE. Thank you, Juliana L’Heureux, chair of
the ANA-Maine legislative committee, for bringing this to
fruition! Kudos for picking up the ball and running with it!
Researching our ANA-Maine centennial and the launch
of the Maine State Board of Nursing, an initiative that was
President’s Message continued on page 14
current resident or
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PAID
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A Nurse Comments on Nursing .............2
Editor’s Opinion .........................3
Save the Date! .........................3
Joint Resolution Recognizing the Centennial
of Maine Nursing ......................4
Nurses in the News ....................6-7
A Vision Becomes a Reality ................7
CE Calendar ...........................8
Index
Nurses’ Work: Keeping Patients Safe
Parts I and II ............................10
Burnout and the Registered Nurse: The
Implications of Leadership Style ..............12
Nursing Summit ...........................13
Membership Application .....................14
Poetry Corner .............................15
State Senator Emily Cain for Congress ..........15

Page 2 ANA Maine Journal May, June, July 2014
A Nurse Comments on Nursing
by Annelle Beall, MSN, RN, CNN, NE-BC
As a master’s-prepared,
certified nurse executive, I am
familiar with nearly all aspects
of acute care. Nevertheless,
I lacked experience from the
perspective of an acutely ill
patient until a recent 23-day
hospitalization in Portland.
This experience proved to me
that competent, compassionate
nursing care is being practiced
Annelle Beall
routinely in Maine hospitals.
In early January, transient eschemic (TIA) symptoms took
me to the emergency department. It was discovered that I had
thrombotic thrombocytopenia purpura (TTP).
I found it difficult to keep track of time. From my admission
to the community hospital to the first several days at the large
academic medical center, much of the time is accessible to me
as only brief moments, seemingly as in a dream, or that time is
totally lost. I became unresponsive early in my hospitalization
at the medical center and required several days in the critical
Interprofessional Graduate Certificate Program in Gerontology
The Interprofessional Graduate Certificate Program in Gerontology is
designed to strengthen the knowledge, skills, and abilities of health
care and human service professionals who provide care to older adults
in a variety of settings.
This 12-credit certificate program, consisting of five (5) courses, is offered online.
GRN 500: Opportunities and Challenges of Aging (3 cr.). Fall semester
GRN 501: Life Transitions and Health in Aging (3 cr.). Spring semester
GRN 502: Interventions for Care of Older Adults in Diverse Settings (3 cr.). Summer 2014
GRN 503: Health Policy Issues of an Aging Population (2 cr.). Fall semester
Integrative Seminar in Gerontology (1 cr.). Course in development; first offering
planned in Spring 2015.
For more information, please go to: http://umaineonline.umaine.edu/ and
http://umaine.edu/gerontology/
The University of Maine is an equal opportunity/affirmative action institution.
care unit. In addition to necessary plasma exchanges, as often
as twice a day, I received red cell transfusions, chemotherapy
with rituximab and high-dose intravenous steroids. As if the
other effects of the TTP were not enough, I had a lacunar stroke
while hospitalized. (Cognitive deficits and complications are
not uncommon with TTP.) Truly remarkable were the many
encounters with nurses along every step of this journey to
recovery.
An initial assessment of my illness in the emergency
department was professional, and the nurse not only cared for
me but for my spouse as well. He also was sensitive to the fact
that as a hospital employee, I was concerned that I might receive
special treatment when admitted (something I discouraged).
There is little I remember about the next 24 hours, but I
remember a nurse talking with me about how my blood pressure
medication would need to be changed while hospitalized and
why.
Upon my transfer to the academic medical center, the nurse
introduced himself and provided a clear and simple explanation
of what would happen next. This was helpful as my cognition
was less than adequate. He also let me know that my spouse was
on the way up, which was a huge concern to me at the time.
There was a night nurse in critical care that I remember very
well, however. She did something that was truly remarkable.
My spouse had gone home that night. It was early the following
morning, and I wanted to speak with my spouse. The nurse
dialed the number and gave me the phone. Having me alert
and asking for a specific cola beverage was one of the most
meaningful things that could have happened for my spouse.
The relief of my being responsive was monumental. It is very
likely that the nurse had no idea how important that was to the
two of us during this terrifying time. It is also likely that she
does this kind of thing every day.
We particularly connected with one of the floor nurses when
I was transferred out of critical care. She explained the therapies
I would be receiving from a nursing perspective, and never
assumed that she shouldn’t explain. Furthermore, she made it
clear that our participation was crucial to the treatment plan. My
opinion mattered. Even if I was not assigned as her patient, she
followed my progress when she was on duty.
When I had the stroke, in a matter of seconds, it seemed,
multiple individuals came into the room. I remember seeing
the words “nurse practitioner” on neurology’s nametag. I was
unable to voice anything but the word “stroke,” but I was trying
to tell my spouse that this was the “stroke team.” Oddly, I did
not feel scared because the Nurse Practitioner was so competent.
Other nurses during my hospital stay understood how I
wanted to receive my medications was important. One nurse
reassured me that he would interrupt me only if it were required
by regulation, because he knew I had experienced little sleep the
previous night. He emphasized that sleep was essential to my
recovery; therefore, all care would be concentrated around any
necessary interruption.
During plasma exchanges, the nurses made sure I was
comfortable and taught me about the process whenever I was
awake enough to receive information. Never did I feel I was
a burden (although there were times when I likely was an
unplanned addition to their schedules).
Advocacy, education, clinical competency, and compassion
— these are all expectations of us as nurses.
How rewarding it is to see, even if it was from the other side
of the delivery model.
Annelle Beall, MSN, RN, CNN, NE-BC, is Nurse Manager
of 2B Inpatient Surgical, CCU and Dialysis, at Mercy Hospital.
She also serves as Secretary of ANA-MAINE. She is the
Secretary of the Board of ANA-Maine.
www.anamaine.org
Published by:
Arthur L. Davis
Publishing Agency, Inc.
Published by the
AMERICAN NURSES ASSOCIATION-MAINE
a constituent member association of the
American Nurses Association
E-mail: info@anamaine.org
Web Site: www.anamaine.org
P.O.Box 1205,
Windham, ME 04062
ANA-MAINE BOARD OF DIRECTORS
Irene J. Eaton, MSN, RN, CS
President, Kennebunk
irene.bancroft@anamaine.org
Patricia Boston, MSN, RN, RRT
First Vice President, Biddeford
Juliana L’Heureux, BS, RN, MHSA
Second Vice President, Topsham
Rebecca Quirk, MSN, RN IV, CNL, CPON, CPSTI
Treasurer, Scarborough
Annelle Beall, MSN, RN, CNN, NE-BC
Secretary, Scarborough
Jill Bixby, APRN, MS, CHPN
Director, Oakland
Patricia Boston
Director
Joyce Cotton, DNP, APRN-BC
Director, Kennebunk
April Giard, PMH-NP
Director, Orland
Rosemary Johnson, PhD, APRN-BC
Director, South Portland
Catherine Lorello-Snow, PMHRN-BC
Director, Portland
Contents of this newsletter are the opinion of the author
alone and do not reflect the official position of ANA-
MAINE unless specifically indicated. We always invite
leaders of specialty organizations to contribute.
ANA-MAINE EDITORIAL COMMITTEE
Juliana L’Heureux, BS, RN, MHSA (Editor)
Rosemary Henry, MS, RN
Millicent G. Higgins, EdD, RN
Sue McLeod, BSN, RN, BC
Terri Matthew, RN, BSN
Paul Parker, BSN, RN
Jenny Radsma, PhD, RN
Nancy Tarr, MSN, ANP, FNP
We welcome submissions, but we reserve the right to reject
submission of any article. Send to publications@anamaine.org. CE
calendar listings are without charge.
Attribution: We do not knowingly plagiarize. We encourage
our authors to fact check their material but we do not assume
responsibility for factual content of ads or articles.
For advertising rates and information, please contact Arthur L.
Davis Publishing Agency, Inc., 517 Washington Street, PO Box 216,
Cedar Falls, Iowa 50613, (800) 626-4081, sales@aldpub.com. ANA-
Maine 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. Published quarterly every February, May,
August and November.
Acceptance of advertising does not imply endorsement or
approval by ANA-Maine 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. ANA-Maine 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 ANA-Maine or those of the national or
local associations.
Postal Address corrections: This list of addressees is obtained
from the Maine State Board of Nursing (MSBON) each issue. To
keep your address current for these mailings, simply notify the
MSBON of any needed changes in your postal mailing address.
Permission must be obtained from ANA Maine to replicate or
reproduce any content from ANA Maine Journal.

May, June, July 2014 ANA Maine Journal Page 3
Editor’s Opinion
Creating Tomorrow’s
Nursing History
by Juliana L’Heureux
SAVE THE DATE!!!
IT’S A BIRTHDAY PARTY AND YOU ARE INVITED!!!
A nursing history group meets regularly at the Maine State
Board of Nursing in Augusta for the purpose of putting together
a retrospective Centennial of professional nursing in Maine. In
documenting and writing about the past, these historians are also
creating a baseline for the future.
In 1914, the American Nurses Association incorporated in
Maine, where the leaders launched the legislation in 1915 to
create the Maine State Board of Nursing. This was the beginning
of “registered nurses” in Maine. Over the past 100 years, many
historic nursing heroes have spoken to those of us who are
documenting their interesting stories. Listening to nurses who are
Juliana L’Heureux
teaching us about the past reminds us about how nurses today are
creating our generation’s history. What will nurse historians report
when the Bicentennial history of Maine nursing is being assembled?
Notably, the legislative Joint Resolution to celebrate the Centennial of Maine Nursing will be
included in future annals. (A copy of this resolution is included in this newspaper) Appreciation
will be extended to Maine State Rep. Erik Jorgensen of Portland and Rep. Anne Graham of
North Yarmouth, a nurse practitioner, who both led the legislative initiative recognizing the first
100 years of Maine’s registered nurses.
Moving forward, history will recognize 2014 as the year when Ann Sossong, PhD, RN,
received recognition as the first professor of nursing at the University of Maine in Orono. She is
also the Maine nursing leader who is coordinating the Centennial committee.
Most important, future historians will applaud Maine’s nurses for continuing to provide expert
quality care to our patients, while the challenges of transitioning from traditional hospitals to high
technology are changing the way health care is managed.
On September 27, 2014, the Centennial ANA-MAINE annual meeting being planned at
two locations at University of New England in Biddeford Pool and at the University of Maine
in Orono, will launch nursing’s future with a celebratory theme titled “Innovation, Integration,
Influence.” Leadership from Anne Napier will certainly be applauded when future nurse
historians reflect on the accomplishments of today’s professional leaders. Included in the
futuristic planning is the use of interactive technology (ITV) allowing for statewide participation.
Certainly, today’s nursing leaders will be celebrated by future generations. We want those who
write our bicentennial stories to recognize how nursing’s success was built upon the dedication
and caring of extraordinary and inspirational leaders of the past and the present, who were
challenged to earn the public’s trust. To that end, all nurses are cordially invited to celebrate at our
Centennial birthday party.
Be sure to clip the “save the date” announcement published in this newsletter and make a
point of participating and becoming a part of nursing history!
The Nursing Centennial Committee members are: Ann Sossong PhD. RN, Susan Henderson,
MSN RN, Juliana L’Heureux, BS RN MHSA, Myra Broadway, JD MS RN, Elizabeth Clark
PhD RN, Valerie Hart EdD APRN PMHCMS-BC, Martha Eastman PhD MS BS and Marla
Davis, MSN RN.
WHAT: “CELEBRATING 100 YEARS OF NURSES LEADING THE WAY IN
MAINE”
ANA-Maine Conference, Birthday Party and Annual Meeting
WHEN: SATURDAY, SEPTEMBER 27TH, 8:00 AM-4:30 PM
LOCATION: Attend at either of two sites—at University of New
England in Portland or at University of Maine in Orono. Watch the
ANA-ME web site for more details.
PROGRAM: Watch for more details.
For 100 years, Maine nurses have been leaders in health care and patient
care, providing skills, knowledge, leadership, inspiration and innovation
to Maine residents and patients. In honor of our past leaders and to learn
from our current leaders and colleagues, ANA-Maine is sponsoring a
conference for all Maine nurses. So that we may more fully appreciate our
past, take pride in our present, and be inspired for our future:
Presenters will focus on Leadership, New Ideas and Initiatives, and
Interdisciplinary Collaboration.
We want nurses from all over the state to be able to attend
presentations by nationally- known nurses, Maine nurses, and nursing
students who represent our future, so:
The conference will be held at two sites simultaneously—at the
University of New England-Portland campus, and at the University of
Maine-Orono campus.
Sites will be connected by interactive video conferencing.
Live speakers will be at both locations. Morning Keynote speaker,
at UNE, will be the incoming ANA President. Afternoon Featured
Speaker, at UMO, will be past-ANA President Mary Foley.
CNEs will be available at both sites.
At the provided luncheon, Annual Awards will be presented to
outstanding Maine nurse leaders.
AND….we will have a birthday cake to help us celebrate.
So save the date: Saturday, September 27, and share in the journey as
nurses continue to lead the way in Maine for the next 100 years.
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Page 4 ANA Maine Journal May, June, July 2014
State of Maine
In the Year of Our Lord Twenty Fourteen
JOINT RESOLUTION RECOGNIZING THE
CENTENNIAL OF MAINE NURSING
Representative Anne Graham and
Erik Jorgensen
WHEREAS, Maine nurses provide professional and high-quality health
care for people in all parts of the State when and where it is needed, including
in urban, rural, island and wilderness settings; and
WHEREAS, Maine nurses provide their services in hospitals, in
hospice, public health and emergency settings, in homes, ‘in educational,
governmental, industrial and private facilities, in
long-term care, mental health, surgical care and obstetrical services
settings, in physicians’ practices and in community health centers; and
WHEREAS, quality health care provided by Maine nurses has long been
supported by the American Nurses Association of Maine, or ANA-Maine,
which before 2001 was known as the Maine State Nurses Association; and
WHEREAS, ANA-Maine has been a constituent of the American Nurses
Association since 1914, and nursing practice in Maine has been registered by
the State Board of Nursing since 1915; and
WHEREAS, it is the mission of the State Board of Nursing to protect the
public health and welfare in the area of nursing practice, and it is the mission
of ANA-Maine to work for the improvement of health standards and the
availability of health care services for all Maine people; and
WHEREAS, it is also the mission of ANA-Maine to foster high
standards for nursing and to promote the professional development of nurses;
and
WHEREAS, ANA-Maine advocates for nurses and promotes the
recruitment and retention of nurses in Maine; and
WHEREAS, nursing education has grown and expanded to meet the
needs of a changing health care system to include certified registered nurse
anesthetists, certified nurse midwives, nurse practitioners and clinical nurse
specialists; now, therefore, be it
RESOLVED: That We, the Members of the One Hundred and Twentysixth
Legislature now assembled in the Second Regular Session, on behalf
of the people we represent, take this opportunity to recognize the 100th
Anniversary of nursing practice and education in the State of Maine; and be
it further
RESOLVED: That a suitable copy of this resolution, duly authenticated
by the Secretary of State, be transmitted to, ANA-Maine.
Susan Henderson and Margaret Hourigan with the
Nursing Centennial Exhibit at the 13th Annual Maine
Nursing Summit held on March 19, 2014, at the
Augusta Civic Center
ATTEST:
Picture Credit: Juliana L’Heureux
House of Representatives
Read and Adopted
March 4, 2014
Sent for Concurrence
Ordered Sent Forthwith
Millicent M. MacFarland
Clerk of the House
In Senate Chamber
Read and Adopted
March 5, 2014
In Concurrence
Darek M. Grant
Secretary of the Senate
Mark W. Eves
Speaker ofthe House of Representatives
ATTEST:
Justin L. Alfond
President of the Senate

May, June, July 2014 ANA Maine Journal Page 5
Sponsored By:
Rep. Erik C. Jorgensen of Portland
Cosponsored By:
President Justin L. Alfond of Cumberland
Rep. Henry John Bear
of the Houlton Band of Maliseet Indians
Rep. Paulette G. Beaudoin of Biddeford
Rep. Roberta B. Beavers of South Berwick
Rep. Seth A. Berry of Bowdoinham
Rep. Russell 1. Black of Wilton
Rep. Andrea M. Boland of Sanford
Rep. Sheryl J. Briggs of Mexico
Rep. Joseph E. Brooks of Winterport
Rep. James 1. Campbell, Sr. of Newfield
Rep. Katherine W. Cassidy of Lubec
Rep. Kathleen D. Chase of Wells
Rep. Justin Mark Chenette of Saco
Rep. Benjamin M. Chipman of Portland
Rep. Tyler Clark of Easton
Rep. Janice E. Cooper of Yarmouth
Rep. Dale J. Crafts of Lisbon
Rep. Matthea Elisabeth Larsen Daughtry of
Brunswick
Rep.MichaelGilbertDevinofNewcastle
Rep. James F. Dill of Old Town
Rep. Mark N. Dion of Portland
Rep. Ann E. Dorney of Norridgewock
Rep. Jeffrey Evangelos of Friendship
Speaker Mark W. Eves of North Berwick
Rep. Richard R. Farnsworth of Portland
Rep. Joyce A. Fitzpatrick of Houlton
Rep. Lori Fowle of Vassalboro
Rep. Kenneth Wade Fredette of Newport
Rep. Aaron M. Frey of Bangor
Rep. Drew M. Gattine of Westbrook
Rep. Sara Gideon of Freeport
Rep. Paul E. Gilbert of Jay
Rep. Adam A. Goode of Bangor
Rep. Anne P. Graham of North Yarmouth
Rep. Gay M. Grant of Gardiner
Rep. Scott M. Hamann of South Portland
Rep. Denise Patricia Harlow of Portland
Rep. Lance Evans Harvell of Farmington
Rep. Craig V. Hickman of Winthrop
Rep. Barry J.. Hobbins of Saco
Rep. Brian L. Hubbell of Bar Harbor
Rep. Dennis L. Keschl of Belgrade
Rep. L. Gary Knight of Livermore Falls
Rep. Victoria P. Kornfield of Bangor
Rep. Chuck Kruger of Thomaston
Rep. Walter A. Kumiega III of Deer Isle
Rep. Karen Kusiak of Fairfield
Rep. Michel A. Lajoie of Lewiston
Rep. Thomas R W. Longstaff of Waterville
Rep. W. Bruce MacDonald of Boothbay
Rep. Joyce A. Maker of Calais
Rep. Richard S. Malaby of Hancock
Rep. Donald G. Marean of Hollis
Rep. Timothy r.Marks of Pittston
Rep. Andrew T. Mason of Topsham
Rep. Anne-Marie Mastraccio of Sanford
Rep. Paul D. McGowan of York
Rep. Kimberly J. Monaghan-Derrig
of Cape Elizabeth
Rep. Matthew W. Moonen of Portland
Rep. Stephen W. Moriarty of Cumberland
Rep. Catherine M. Nadeau of Wins] ow
Rep. Mary P. Nelson of FaLmouth
Rep. William F. Noon of Sanford
Rep. Ann E. Peoples of Westbrook
Rep. Matthew J. Peterson of Rumford
Rep. Joshua R. Plante of Berwick
Rep. Jane P. Pringle of Windham
Rep. Helen Rankin of Hiram
Rep. Megan M. Rochelo of Biddeford
Rep. Margaret Rotundo of Lewiston
Rep. Diane Russell of Portland
Rep. Deane Rykerson of Kittery
Rep. Linda F. Sanborn of Gorham
Rep. Deborah J. Sanderson of Chelsea
Rep. Robert J. Saucier of Presque Isle
Rep. John C. Schneck of Bangor
Rep. Stanley Byron Short, Jr. of Pittsfield
Rep. Heather W. Sirocki of Scarborough
Rep. Madonna M. Soctomah
of the Passamaquoddy Tribe
Rep. Peter C. Stuckey of Portland
Rep. Charles Kenneth Theriault of
Madawaska
Rep. Ryan D. Tipping-Spitz of Orono
Rep. Sharon Anglin Treat of Hallowell
Rep. Beth P. Turner of Burlington
Rep. Arthur C. Verow of Brewer
Rep. Windol C. Weaver of York
Rep. Joan W. Welsh of Rockport
Rep. R. Wayne Werts of Auburn
Rep. Alexander Reginald Willette of Mapleton
Sen. James A. Boyle of Cumberland
Sen. David C. Bums of Washington
Sen. Emily Ann Cain of Penobscot
Sen. John J. Cleveland of Androscoggin
Sen. Ronald F. Collins of York
Sen. Margaret M. Craven of Androscoggin
Sen. David E. Dutremble of York
Sen. Patrick S.A. Flood of Kennebec
Sen. Stanley J. Gerzofsky of Cumberland
Sen. Geoffrey M. Gratwick of Penobscot
Sen. James M. Hamper of Oxford
Sen. Anne M. Haskell of Cumberland
Sen. Dawn Hill of York
Sen. Troy D. Jackson of Aroostook
Sen. Christopher K. Johnson of Lincoln
Sen. Roger J. Katz of Kennebec
Sen. Colleen M. Lachowicz of Kennebec
Sen. Brian D. Langley of Hancock
Sen. Garrett Paul Mason of Androscoggin
Sen. Edward J. Mazurek of Knox
Sen. Rebecca J. Millett of Cumberland
Sen. John L. Patrick of Oxford
Sen. Gary E. Plummer of Cumberland
Sen. Thomas B. Saviello of Franklin
Sen. Roger L. Sherman of Aroostook
Sen. Michael D. Thibodeau of Waldo
Sen. Douglas A. Thomas of Somerset
Sen. John L. Tuttle, Jr. of York
Sen. Linda M. Valentino of York
Sen. Eloise A. Vitelli of Sagadahoc
Sen. Rodney L. Whittemore of Somerset
Sen. Richard G. Woodbury of Cumberland
Sen. Edward M. Youngblood of Penobscot
In Testimony Whereof, I have caused the
seal of the State to be hereunto affixed,
GIVEN under my hand at Augusta, this fifth
day of March in the year twenty fourteen.
Matthew Dunlap
Secretary of State
The members of OMNE extend a heartfelt
thank you to all nurses who just celebrated
Nurses Week.
Your Strength, Commitment, and Compassion
Make a difference!
To learn more about
OMNE membership, please visit
www.omne.org
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Page 6 ANA Maine Journal May, June, July 2014
Special Thanks to our very Dedicated Nurses
for the Excellent Care You Provide to Our
Residents Each and Every Day!
Full Time Licensed Nurse positions in our
This is a great opportunity to earn a competitive wage and
make a difference for our residents as you work with an
effective and committed team of healthcare professionals.
New Graduates encouraged to apply for our new Preceptor
program which includes tuition reimbursement.
Also hiring per diem RNs, LPNs, CNAs & CNA-Ms
Please send resumes to:
335 Stillwater Ave, Bangor, ME 04401
Or call (207) 947-1111
Nurses in the News
Nursing Leader Colleen Hilton RN
Mayor of Westbrook Maine
by Juliana L’Heureux
Nursing is ranked by the
public as the most trusted
profession. For Colleen Hilton
of Westbrook, this trust
transcended into community
leadership. In addition
to being the CEO of the
VNA and Hospice of South
Portland, she is the mayor of
the city of Westbrook, which
is also her hometown.
Colleen Hilton
Mayor Colleen Noyes
Hilton grew up in Westbrook. She comes from a large
family. The daughter of Malcolm and Mary Jane Noyes,
Hilton has two brothers and four sisters, several nieces
and nephews and great-nieces and nephews. She has been
married for 31 years to William Hilton and together they
have three children — William N., Emily and John, all
graduates of Maine colleges. This year, they welcomed
their first grandchild, Colleen Mary.
When asked about her public service commitments,
Hilton acknowledges her parents’ great influence,
instilling the values of public service that place the
needs of others before self and make a difference in the
community. Her father, Malcolm, was a city councilor
when they were called aldermen. He also served on
the Westbrook Housing Authority Commission for 20
years. Her siblings serve on other boards and committees
in Westbrook. Hilton says her family taught her the
importance of helping others. “My family has always had
a rich tradition of commitment to the city of Westbrook,”
she says.
As the CEO of the busy VNA and Hospice, she also
serves as the Vice President for Home Health and Hospice
for Mercy Health System of Maine.
Hilton completed her Bachelor of Science in Nursing at
the University of Southern Maine. She holds a Certificate
of Graduate Studies in Health Policy and Management
from the Muskie Institute of USM. She is a graduate
of the 2008 class of Health Leadership Development, a
partnership between the Daniel Hanley Center for Health
Leadership and the Institute for Civic Leadership.
In 2011, Hilton was recognized a one of five Maine
Women to Watch by Mainbiz Magazine. More than
85 Maine business leaders from across the state were
nominated for this honor, and she was selected to
represent the dual role of healthcare provider and the
Mayor of Westbrook.
As a passionate advocate for home health and hospice,
she has served on the Home Care Alliance of Maine
Board of Directors in several capacities. She’s a member
of the Organization of Maine Nurse Executives (OMNE)
and ANA-Maine, and she serves in several healthcare
professional advisory roles. She also served on the board
of directors for a local nursing home. Hilton continues to
serve as the vice chair of the Cumberland District Public
Health Council, advocating for public health along with 30
other member organizations.
In her local community, Hilton has served as a member
of the Westbrook School Committee for 10 years and as
its chair. She was a 2007 recipient of the Department of
Education Commissioner’s Recognition award for her
work in Truancy, Dropout and Alternative Education.
She continues to stay involved with advocacy for children
and education and currently serves as a member of the
Westbrook Children’s Cabinet, a joint effort with United
Way of Greater Portland and area business and civic
leaders to further enhance programs to ensure children are
successful in our community and schools.
In 2009, Hilton was first elected mayor of Westbrook
and is currently serving her third term. She is the first
female elected to this office in the city’s history. She
enjoys hearing from nurses who might be considering a
role in public policy leadership. Feel free to call her at 591-
8110 or email her at chilton@westbrook.me.us.
Check the website http://www.vnahomehealth.org/ for
more information.
The extraordinary
dedication of our nurses
is evident from day 1.
With so many outstanding professionals
working together, it’s no wonder our
nursing staff is one of the country’s best.
Because at our core, excellence
in patient care is what matters most.
It’s why for the past eight years, the
Maine Medical Center nursing staff
has held Magnet status, the nations’
highest mark for quality patient care.
www.mmc.org

May, June, July 2014 ANA Maine Journal Page 7
A Vision Becomes
a Reality:
Recollections in Honor of
Sister M. Consuela White
by Susan Henderson, MSN, RN
There’s an opportunity
to recognize the leadership
of Sister M. Consuela
White and to participate in
the Sister Consuela White
Scholarship Fund.
When Sister Consuela
retired as the founder of
the nursing program at
Saint Joseph’s College, she
gave me, a nursing faculty
member, a box of pictures Susan Henderson
from a drawer in her office.
I put the box away and when she retired, gave it to her
department chair, who had the pictures scanned into
a PowerPoint presentation that was given to me at my
May 2011 retirement party at the college.
Sadly, Sister Consuela died that May.
Over the summer, I thought a lot about Sister
Consuela and looking at the pictures. There were pictures
of the first capping and pinning. Fran Linehan, a nursing
faculty member, who was hired before the first class
started its sophomore year, Barbara Malonson Daggett,
who graduated in the class of 1982, and Dr. Carol Seavor,
who replaced Sister Consuela as department chair, got
together and realized that they wanted to do something
to remember Sister. We wanted to have something
published that would tell future nursing students and
faculty about the history of the nursing department and
Sister Consuela. With editing by Charmaine Daniels and
graphic design by Renee LeBrun, they wrote A Vision
Becomes a Reality:
Recollections in
Honor of Sister M.
Consuela White
(2012/2013. Barbara
Malonson Daggett’82,
Susan Henderson,
Francis Linehan and
Carol Seavor).
Saint Joseph’s
College has published
this story and a
copy will be given
to individuals who
donate $20 or more
to the Sister Consuela
White scholarship
fund at Saint Joseph’s College. It is hoped that you will
order a copy and find this history meaningful and your
generous support will help to grow the scholarship fund
for current and future nursing students at Saint Joseph’s.
To participate, please contact Heather Plati in the
Office of Institutional Advancement at Saint Joseph’s by
emailing hplati@sjcme.edu or call 207-893-7898.
The Summer Camp, a nonprofit
residential summer camp,
provides girls from low-income
families and foster homes with
the opportunity to experience a
sleep-away camp. Our summer
sessions for 2014 will be held at a private camp in Washington, Maine,
located 20 minutes from Augusta. We are an American Camp Association
accredited camp celebrating our 29th season this summer. We are seeking
to hire a nurse for the following dates: June 21st–June 30th and
Travel allowance provided.
If you are interested in MAKING A DIFFERENCE this summer, please
contact: Tracy St. Onge-May, 8 Church Street, Bridgton, ME 04009
thesummercamp.org
Nurses in the News
Donna DeBlois Appointed
CEO of Home Health
by Juliana L’Heureux
Donna DeBlois, RN,
BSW, MBA, MSB, has
been appointed as President
and CEO of HomeHealth
Visiting Nurses in Saco ME.
DeBlois served as interim
President and CEO of the
agency since October 2013.
Judith Stone, the chair of the
HomeHealth Visiting Nurses
said the Board of Trustees
Donna DeBlois
search committee worked
with an independent firm to find a permanent candidate
for the position. “After an extensive search, the Board
clearly expressed confidence and enthusiasm for Donna’s
leadership abilities, her engagement with staff, and the
visionary path she has set forth for HomeHealth Visiting
Nurses” she said.
DeBlois has more than 30 years of experience in the
home health field, mostly in Maine. Prior to accepting
No Campus Visits
Liberal Credit Transfers
Competitive Tuition
Classes That Fit Your Schedule
AMHC provides competitive pay and a supportive team environment.
Our mission is to provide comprehensive mental health, substance
abuse treatment services to Aroostook, Washington and Hancock
County communities.
❍ Psychiatric Nurse Practitioners
Recruitment is underway for Master Level Psychiatric Nurses who are
independently licensed in the State of Maine. Primary responsibilities
are to provide psychiatric assessments and medications management,
as well as consultation to multidisciplinary care teams.
This position requires a Masters Degree that represents study in
advanced clinical practice in a selected area of psychiatric nursing, and
passing of a national certification examination. This position requires
the individual to be independently licensed as an Advanced Practice
Nurse by the Maine State at time of hire. AMHC is also NHSC approved
employer.
Salary commensurate with experience. Assistance also available for
interview, relocation and licensure expense reimbursement.
Brittany Haines
Human Resource Specialist
AMHC
P.O. Box 1018, Caribou, Maine 04736
Email to:
www.amhc.org
AMHC is a non-profit organization and an Equal Opportunity Employer.
the interim CEO role at HHVN, she served as executive
director of Kno-Wal-Lin Homecare and vice president of
Community Health for Pen Bay Healthcare in Rockland.
Her professional leadership experience includes
positions with Homecare and Hospice Alliance of
Maine, OMNE Nursing Leaders of Maine and the
Board of the National Association for Homecare and
Hospice. Moreover, she served in leadership positions
with healthcare industry associations both on a state
and national level. She earned both her MBA and MSB
degrees from Husson College in Bangor, her BSW from
the University of Maine and her nursing degree from
CMMC School of Nursing.
Contact DeBlois at the website http://www.homehealth.
org/.
5th Annual Patient Safety Academy
Friday, September 5, 2014
9 am - 4 pm
University of Southern Maine,
Portland Campus, Abrombson Center
All persons interested in or engaged in patient safety are
invited to attend the Patient Safety Academy.
ANA continuing nursing education credits will be
provided for eligible participants.
Registration is $50 (with a discounted rate of $25 for students).
For more information, please visit: http://usm.maine.edu/muskie/psa
or contact: Judy Tupper, DHEd, CHES, CPPS, at
Director of Nursing
If you have an adventurous spirit and a
yearning to live the simple and good life,
come join us in paradise!
We are searching for a Director of Nursing who will embrace
our Mission to “provide personalized service to support the
according to our core values of Integrity, Respect, Compassion,
Stewardship and Excellence.
Cordova Community Medical Center is a 23 bed Critical Access
Hospital that includes a Family Practice Clinic, Emergency
The Medical Center is a warm, friendly and caring work
environment with a very capable and knowledgeable staff. We
have between 8-12 geriatric residents living in our Long Term
Care facility; we all love and care for them as members of our
family. We also serve a close-knit community of approximately
2100 people year round that can boom to around 5000 between
May and September every year during the fishing season.
Cordova Community Medical Center (CCMC) may be the career
opportunity you are looking for. In addition to accruing paid time
insurance. CCMC is a participant in the State of Alaska’s Public
Employees Retirement System (PERS) and we offer employees
the option to voluntarily enroll in a 403b Tax Sheltered Annuity.
Employees are eligible for membership with Denali Alaskan
Federal Credit Union and receive a discount in the cafeteria and
on annual passes for the Bidarki Recreation Center and Bob
Korn Swimming Pool.
Please contact:
907-424-8000
Tim James, HR Coordinator
www.cdvcmc.com

Page 8 ANA Maine Journal May, June, July 2014
Although we attempt to be as accurate as possible, information concerning events is published as submitted. We do not
assume responsibility for errors. If you have questions about any event, please call the event planner directly.
If you wish to post an event on this calendar,
issue.
Send items to publications@anamaine.org. Please use the format you see below: date, city, title, sponsor, fee and contact
information. There is no charge to post an educational offering.
Advertising: To place an ad or for information, contact sales@aldpub.com.
ANA-MAINE is the ANCC-COA accredited Approver Unit for Maine. Not all courses listed here provide ANCC-COA
credit, but they are printed for your interest and convenience. For more CNE information, please go to www.anamaine.org.
To obtain information on becoming an ANCC-COA CNE provider, please contact anamaine@gwi.net.
USM/PCE indicates the class is offered through University of Southern Maine/Center for Professional and Continuing
Education. For course descriptions, visit http://usm.maine.edu/pdp/pdp-certificate-programs, http://www.usm.maine.edu/
muskie/continuing-education. (The previous website address no longer works) or call 207-780-5900 or 800-787-0468 for a
catalog.
Most classes are held at the new Abromson Community Education Center in Portland, conveniently located just off I-295.
Free parking nearby.
CCSME indicates class is held by the Co-Occurring Collaborative Serving Maine.
For PESI HealthCare seminars in Maine, visit http://www.pesihealthcare.com.
Visit the ANA-MAINE Calendar of Events at: http://www.anamaine.org/calendar.cfm for more information for additional
upcoming events.
Are you passionate about nursing education? Do you
have experience in adult learning and nursing education,
as well as a baccalaureate or graduate degree in nursing?
If so, ANA-MAINE has a spot just for you on its
Continuing Nursing Education Committee! ANA-MAINE
is an Accredited Approver of Nursing Continuing Nursing
Education by the American Nurses Credentialing Center’s
Commission on Accreditation (ANCC-COA). Make use
of this wonderful opportunity to facilitate the ongoing
education of your peers, and to become involved in your
nursing organization. For more information, contact Dawn
Wiers at 207-938-3826, or cne@anamaine.org.
Looking for cutting edge training in the
management of STDs and HIV?
Visit www.RatellePTC.org to view the latest
course offerings and register for a course
that is convenient for you. Many courses
offer free CME/CEU credit.
Opening for CNE Program Reviewers
Sylvie Ratelle STD/HIV
Prevention Training Center of New England
Cutting edge training since 1995
RN to Bachelor of Science Degree. Blended online
and classroom program, University of Southern Maine,
College of Nursing and Health Professions. Contact Amy
Gieseke, Program Coordinator for USM’s Online/Blended
Programs, 207-780-5921 or agieseke@usm.maine.edu.
RN-BSN distance education for licensed RNs wishing
to complete the BSN degree; exclusively online program of
study. University of Maine at Fort Kent. Contact Professor
Diane Griffin, coordinator, 207-834-8622 or dgriffin@
maine.edu.
USM/ONLINE. Certificate Program in
Gerontology (15 undergraduate credits). Students may
complete the five courses in the program in one year
by taking one course in each 7-week session or they
may proceed at their own pace. For more information,
visit usm.maine.edu/online/online-certificate-programgerontology
or call 207-780-5900 or 1-800-787-0468.
May 2014
16 PESI/Portland. Treatment Resistant Anxiety,
Worry & Panic: 60 Effective Strategies. 8 a.m.-4 p.m.
Speaker: Jennifer L. Abel, Ph.D. Early Registration:
$189.99, available until April 26. For additional
information, call 1-800-843-7763 or visit http://www.
pesihealthcare.com.
19 USM/PCE/Portland. Using Motivational
Interviewing with Chronic Illness (12 contact hrs/1.2
CEUs). Class meets two days, May 19 & 20. Instructor-led
training by Stephen Andrew. $295. For more information,
visit usm.maine.edu/pdp or call 207-780-5900 or 1-800-
787-0468.
19 PESI/Portland. Autism and Other
Neurodevelopmental Disorders: Practical
Strategies to Improve Processing. 8 a.m.-
4 p.m. Speaker: Patricia McGuire, MD FAAP.
Early Registration: $189.99, available until April 29. For
additional information, call 1-800-843-7763 or visit http://
www.pesihealthcare.com.
University of New England. Sigma Theta Tau
. 2 p.m.,
Finley Recreation Center, Portland Campus. For more
information, go to http://kappazeta.nursingsociety.org/
home.
PESI/Portland. The Orthopaedic Patient:
Musculoskeletal Concepts for Acute and Chronic
Disorders. 8 a.m.-4 p.m. $189.99 single advanced
registration or group rate; $199.99 single after May 8. For
additional information, call 1-800-843-7763 or visit http://
www.pesihealthcare.com.
30 PESI/Portland. Rehabilitation Strategies for
Cognitive-Communication Disorders. 8 a.m.-3:30 p.m.
$189.99 single advanced registration or group rate; $199.99
single after May 10. For additional information, call
1-800-843-7763 or visit http://www.pesihealthcare.com.
June 2014
3 PESI/Bangor. Non-Medication Treatments for
ADHD. 8 a.m.-4 p.m. $189.99 single advanced registration
or group rate; $199.99 single after May 14. For additional
information, call 1-800-843-7763 or visit http://www.
pesihealthcare.com.
4 PESI/Portland. Breastfeeding Success: Supporting
the Journey. 8 a.m.-3:30 p.m. $189.99 single advanced
registration or group rate; $199.99 single after May 15. For
additional information, call 1-800-843-7763 or visit http://
www.pesihealthcare.com.
4 PESI/Portland. Non-Medication Treatments for
ADHD. 8 a.m.-4 p.m. $189.99 single advanced registration
or group rate; $199.99 single after May 15. For additional
information, call 1-800-843-7763 or visit http://www.
pesihealthcare.com.
USM/PCE/Portland. Patient Safety Course (100
contact hours/10.0 CEUs) Class meets online for 10 weeks,
June 8-August 16 with faculty member Judith Tupper.
$800. For more information, visit usm.maine.edu/pdp or
call 207-780-5900 or 1-800-787-0468.
11 PESI/Portland. Preventing Post-Operative
Complications Seminar. 8 a.m.-4 p.m. $189.99 single
advanced registration or group rate; $199.99 single after
May 22. For additional information, call 1-800-843-7763
or visit http://www.pesihealthcare.com
11 PESI/Portland. Cognitive Behavioral Therapy and
Mindfulness. 8 a.m.-4 p.m. Speaker: Richard Sears, PsyD,
MBA, ABPP. Early Registration: $189.99, available until
May 22. For additional information, call 1-800-843-7763
or visit http://www.pesihealthcare.com.

May, June, July 2014 ANA Maine Journal Page 9
16 PESI/Portland. Understanding the Needs of The
Dying. 8 a.m.-4 p.m. $149.99 single advanced registration
or group rate; $199.99 single after May 27. For additional
information, call 1-800-843-7763 or visit http://www.
pesihealthcare.com.
USM/PCE/Portland. Health Psychology Institute
(15 contact hours/1.5 CEUs) Class is offered online or
on-site, June 18-20 led by Psychology faculty member
William Gayton. The cost depends on your registration
selection- $175- $475. For more information, visit usm.
maine.edu/pdp or call 207-780-5900 or 1-800-787-0468.
PESI/Portland.
Revolutionizing Diagnosis & Treatment. 8:30 a.m.-4
p.m. Speaker: Martha Teater, MA, LMFT, LCAS, LPC.
Early registration: $99.99, available until June 5. For
additional information, call 1-800-843-7763 or visit http://
www.pesihealthcare.com.
PESI/Portland. Infectious Diseases: Reduce,
Eliminate, Prevent. 8 a.m.-4 p.m. $189.99 single
advanced registration or group rate; $199.99 single after
June 6. For additional information, call 1-800-843-7763 or
visit http://www.pesihealthcare.com.
30 USM/ONLINE. CON 390 Evaluation &
Assessment of the Older Adult (3 undergraduate credits).
Class runs June 30-August 15 with faculty member Susan
Moore. For more information, visit usm.maine.edu/online/
online-certificate-program-gerontology or call 207-780-
5900 or 1-800-787-0468.
30 USM/ONLINE. (3
undergraduate credits). Class runs June 30-August 15 with
faculty member Susan Fineran. For more information,
visit usm.maine.edu/online/online-certificate-programgerontology
or call 207-780-5900 or 1-800-787-0468.
July 2014
10 PESI/Bangor. Ethical Principles in the Practice of
Maine Mental Health Professionals. 8:30 a.m.-4:30 p.m.
$199.99 single advanced registration until June 20. For
additional information, call 1-800-843-7763 or visit http://
www.pesihealthcare.com.
11 PESI/Portland. Ethical Principles in the Practice
of Maine Mental Health Professionals. 8:30 a.m.-4:30
p.m. $199.99 single advanced registration until June 21.
For additional information, call 1-800-843-7763 or visit
http://www.pesihealthcare.com.
16 USM/PCE/Portland. Childhood Psychopathology
Institute (15 contact hours/1.5 CEUs) Class is offered
online or on-site, July 16-18 led by Psychology faculty
member William Gayton. The cost depends on your
registration selection- $175- $475. For more information,
visit usm.maine.edu/pdp or call 207-780-5900 or 1-800-
787-0468.
PESI/Portland. Survival Spanish for Healthcare
Professionals. 8 a.m.-4 p.m. $189.99 single advanced
registration or group rate; $199.99 single after July 3. For
additional information, call 1-800-843-7763 or visit http://
www.pesihealthcare.com.
PESI/Portland. Respiratory Emergencies: Key
Interventions in a Crisis Seminar. 8 a.m.-4 p.m. $189.99
single advanced registration or group rate; $199.99 single
after July 9. For additional information, call 1-800-843-
7763 or visit http://www.pesihealthcare.com.
August 2014
Conference - The
Nursing Profession: History, Analysis of the Present and
Looking Towards Future Directions. August 21 and 22,
2014. www.cma2014.com.
Nursing Faculty Position
Full-time tenure track position available in the Department of Nursing
for Fall 2014. The successful candidate will be able to teach across
the undergraduate curriculum, and demonstrate recent teaching
and clinical experience. Areas of teaching expertise sought include
mental health nursing. Qualified candidates must possess an earned
doctorate or doctoral candidacy, have a research agenda, university
level teaching experience and eligibility for RN licensure in the state of
Maine. Faculty rank and salary are commensurate with qualifications.
The Department of Nursing is located on two campuses in Portland
and Biddeford, Maine. The primary location of this position is Portland.
The University of New England offers a competitive salary. To apply
For information, contact
Human Resources
University of New England
716 Stevens Avenue
Portland, ME 04103
Review of applications will begin immediately and search will remain
open
www.une.edu
Happy Nurses Week
Care Care at a
higher level
Our online
program provides:
• A career-focused education
• Flexible courses designed for
working adults with busy schedules
• Tuition rates on average 15–20% less than
major for-profit online universities
• Supportive advisors who understand your needs
• Rolling admissions and monthly start dates
BEGIN
TODAY
BACHELOR’S AND MASTER’S IN NURSING
Visit online.sjcme.edu/MEnurses or call 800-752-4723 for more information.
In recognition of the heartfelt passion
you display all year long, HomeHealth
Visiting Nurses wishes you a
Happy Nurses’ Week 2014!
For over a century, we have brought
the best in home health to our
patients and families in Southern
Maine. As the leading home health
care agency in the region, we
proudly deliver comprehensive care
with compassion, commitment and
the highest standards of excellence.
Our services are available
throughout York, Cumberland and
southern Oxford Counties.
RN Opportunities in most areas.
Requires at least one year of hands-on nursing experience.
For employment opportunities, please visit
www.homehealth.org

Page 10 ANA Maine Journal May, June, July 2014
Nurses’ Work: Keeping Patients Safe Parts I and II
by Cheryl M. Roberts, BSN, MS, RN, CPHQ
Editor’s note: This is a two-part article. Part I was
first published in the fall 2012. Now, the entire article is
printed, with Part I and Part II appearing side-by-side.
In the 1990s, general satisfaction with and confidence
in healthcare providers and institutions was relatively low
among the public. Stories abounded of substandard care,
including medication overdoses, amputation of the wrong
limb, missed cancer diagnoses, dead babies, botched
transplants, and other serious adverse occurrences.
Medical malpractice premiums skyrocketed. In 1996,
the Committee on Quality of Healthcare in America was
formed by the National Academy of Sciences’ Institute
of Medicine (IOM), and its members, forward thinkers
from health care, science, and business, were charged with
identifying strategies to achieve substantial improvement
in the quality of health care delivered to Americans.
In 1999, the committee
released its initial report,
published a year later as
the part of the Institute
of Medicine’s Quality
Chasm series, entitled To
Err Is Human: Building
a Safer Health System.
The report focused on the
fact that human beings are
inherently error-prone, that
errors could be prevented
by designing systems that
To Err is Human
By the Institute of
Medicine, National
Academy of Sciences
make it easy to do the right
things and hard to do the
wrong things, and that we
could no longer overlook
the issues of quality and
safety staring us in the face. The publication was not
only a groundbreaking summary of mistakes that occur
across the healthcare landscape and that had often been
accepted as “one of those things that happen.” It also
addressed needed changes in the systems and processes in
health care and the strategies to facilitate these changes,
which if undertaken could prevent errors. The committee
concluded that between 44,000 and 98,000 Americans
died every year from preventable medical errors and that
many more experienced, or barely escaped, non-fatal
errors and injuries.
In 2001, a follow-up
report was published by
IOM, entitled Crossing
the Quality Chasm: A
New Health System for
the 21st Century. This
report acknowledged
that patient safety, while
extremely important,
provided only a piece of
the puzzle. This report
issued recommendations
for healthcare providers
and institutions to adopt
a new perspective about
the purpose and aims of
the healthcare system.
Widespread system flaws
were acknowledged
Crossing the Quality
Chasm: A New Health
System for the 21st
Century
By the Committee on
Quality Healthcare in
America
that ultimately affected
millions of Americans and their treatment, dignity,
comfort, satisfaction and finances. The ideas were
revolutionary, involving changes in the structure and
processes of healthcare delivery, including setting new
national priorities for improvement, creating better ways
to disseminate and encourage evidence-based practice,
fostering use of information technology, implementing
payment policies that would reward improvements
in performance, and improving the education of the
healthcare workforce.
Since that time, extensive work has been done in the
field of patient safety. Initially, few facilities were able
to consistently track their performance, but there were
no universal nomenclature and no agreement on what
could or should be measured. Over the course of a few
years, organizations such as The Joint Commission (TJC)
and large third-party payers such as the federal Center
for Medicare and Medicaid Services (CMS) worked
with other groups such as the Leapfrog Group and the
National Quality Forum to standardize measurement
concepts, quality and safety improvements, and reporting
requirements. Public reporting of quality and satisfaction
data became the norm through TJC and CMS. In Maine,
a group of large, self-insured employers organized with
a few interested healthcare partners to create the Maine
Health Management Coalition (MHMC). The MHMC
utilized the already-reported CMS measures and the
Leapfrog Group’s survey information, created some
measures of their own regarding medication safety and
invited healthcare providers to join them in demonstrating
the provision of safe, quality care. The MHMC has
continued to be a leader in the state and nationally
regarding public reporting of comparable data. Some
organizations (like the state of Maine and University of
Maine system) use this information to rank hospitals and
providers and offer incentives to those insured to seek care
at those facilities or providers who are ranked the highest.
Nationally, financial incentives have been successfully
used by CMS to focus attention on areas of concern such
as hospital readmissions, never events, care of patients
with heart conditions, community-acquired pneumonia,
and surgical infection, using evidence-based care to steer
necessary changes. Nurses are at the forefront of many of
these initiatives.
Although many of the efforts are and have been driven
by attempts to address the high cost of health care, many
healthcare providers, especially nurses, are inherently
interested and invested in safe patient care. Whether this
means assuring that patients diagnosed with communityacquired
pneumonia receive their initial antibiotic within
six hours of diagnosis or making sure the right patient has
surgery on the correct body part, nurses play an important
role in overseeing the collaborative care that is regularly
provided. Nurses’ role as patient advocate guarantees them
a place in the forefront of quality and safety improvement
initiatives. In addition to these examples of collaborative
care, there are multiple areas of patient safety that any
nurse can independently address, such as proper patient
identification, medication administration safety, prevention
of serious injury from falls, prevention of healthcareassociated
infections, and understandable patient
education.
Let us briefly examine what is meant by medical
error and adverse event. There are two main distinctions.
First, because patients do regularly experience adverse
outcomes, distinguishing between those outcomes that
occur as a result of medical care and those events that
happen as a result of underlying medical conditions is
necessary. The first is considered a medical error or
patient harm. The Institute for Healthcare Improvement
(2006) defines medical error or harm as “unintended
physical injury resulting from or contributed to by
medical care (including the absence of indicated medical
treatment) that requires additional monitoring, treatment
or hospitalization or that results in death.” The second
distinction, since patients may experience harm in the
absence of error, patient safety literature separates into
preventable and non-preventable adverse events.
Evolution in the area of patient safety has occurred
since the time prior to 1998 when it was not uncommon
to see staff punished if they reported an error. When
Betsy Lehman, a reporter for the Boston Globe, died at
the Lahey Clinic as a result of a chemotherapy overdose
(Allen, 2004), the nurse and pharmacist lost their jobs and
their professional licenses. This punitive philosophy gave
way to that of a blame-free culture to encourage reporting
of errors so the risk for making errors could be addressed.
The philosophy of the blame-free culture gave way to
that of an “accountable culture” and evolved into what is
now referred to as a “just culture.” A just culture is one in
which systems that predispose to error are identified and
remedied, which is distinct from errors of accountability
involving human error (e.g., “slips”) or risky behavior
(taking shortcuts), or even reckless behavior (forgoing
safety precautions), which is contrasted with a “no-blame”
approach (Agency for Healthcare Research and Quality,
n.d.). Wachter (2012) states that just culture contributes to
an “atmosphere of trust in which people are encouraged,
even rewarded, for providing essential safety-related
information.” But, a just culture is also one in which the
providers are clear about “where the line must be drawn
between acceptable and unacceptable behavior.”
Healthcare administrators and providers of care now
recognize that the most common contributor to error is
the process or system that allowed the error to occur.
Generally speaking, the individuals involved are not
unintelligent or bad or negligent, nor are they the actual
cause of the error. Clarification of this premise in recent
years encourages accountability such that individuals who
practice consistently risky behavior or consistently violate
policy or protocols, should indeed be held accountable for
the behavior that puts others — patients and colleagues
— in harm’s way. The method by which processes and
systems are dissected to identify the flaws in a system and
any other factors that influenced an error is known as a
Root Cause Analysis. This analysis is carried out, usually
over the course of several meetings, by having all parties
associated with an occurrence discuss what happened and
ask one simple question: Why? If a process is examined
prior to an error occurring, it is called a Failure Mode
Effects Analysis. This approach is preferable to waiting
until after an error or adverse event has occurred and is
widely practiced in organizations where “near-misses” are
regularly reported. A near-miss event is an error that is
caught or stopped before it reaches the patient.
Part II
Following are two scenarios involving patients and
highly competent caregivers where serious or potentially
serious adverse events occurred. These caregivers intended
to provide (and thought they had provided) exceptional
care to their patients. Nonetheless, their actions missed the
mark for what is considered to be safe, competent practice,
and consequently, the individuals involved were personally
changed, as were the patients and their families, by the
event.
Scenario 1: In the late 1990s, the quality/infection
control department of a small hospital worked
collaboratively with surgeons, nurse anesthetists, the
pharmacist and surgical nurses to assure that patients
having surgery in which a prophylactic antibiotic was
indicated received the appropriate antibiotic in a timely
fashion. The recommendation was that the antibiotic be
given within one hour prior to incision. Since this practice
often occurred two or more hours prior to the incision,
improvement was needed in the process. The system in
place was fairly complex, involving many people, each
with different expectations and functions. The surgeon
generally ordered the antibiotic “on call” to the OR, the
OR nurses went to the med-surg unit to get the patient, and
the nurses on the med-surg unit thought it was their job to
give the antibiotic before the patient left the unit for the
OR. After examining the process, the decision was made
that it would be better if the antibiotic was given after the
patient arrived in the OR area. This change had not been
completely adopted (some nurses found it hard to give up
their usual task), nor had the change been particularly well
communicated (that it was not a choice) and the nurses
on the floor still considered it to be helpful to give the
antibiotic before the patient left the floor.
Nurses’ Work continued on page 11

May, June, July 2014 ANA Maine Journal Page 11
Nurses’ Work continued from page 10
On one particular day, the OR called for the patient.
The floor nurse had mixed the antibiotic but did not have
time to hang it; rather, she handed the bag to the one of
the nurses who had arrived from the OR to get the patient.
The OR nurse and floor nurse exchanged a few words
that were subsequently recognized as misunderstood.
The patient went to the OR, had the scheduled surgical
procedure, and returned to the floor with epidural
analgesia. Pain control was an issue for the patient over
the course of the day and before leaving for the day the
CRNA came up to re-evaluate the patient. She opened the
epidural analgesia box and found the bag with the patient’s
pre-op antibiotic infusing, not the fentanyl mixture she
had anticipated and thought she had used. Fortunately, the
antibiotic, although administered intrathecally, caused no
damage. This medication error was able to be classified as
not causing patient harm.
A review and investigation ensued that identified
that the CRNA thought the prepared I.V. bag contained
fentanyl and did not examine the bag or label, even
though it did not fit easily into the box. The bag had been
assumed to contain fentanyl but was plainly labeled as
the antibiotic. The antibiotic in the OR was premixed in
the pharmacy and labeled with the same size and color
label used for any I.V. admixture. While she thought she
identified the contents of the bag she had been handed,
the CRNA had given it only a cursory glance and never
considered that a mistake had been made. The nurse on
the med-surg unit thought she was being helpful when in
fact she complicated the new procedure.
The areas identified as problematic were:
• Staff members who did not follow protocols for
◦ Administering a medication mixed by someone
else
◦ Identifying a medication prior to administration
• Inconsistent practices regarding preoperative
antibiotics
• Process changes not communicated to all involved
staff members as mandatory
What changes do you think should have been made?
Would you be more heavy-handed in the implementation
of a new procedure? In the real world of multiple
departments caring for the same patient, how could this
problem have been foreseen and prevented?
The following changes were made in the process to
prevent recurrence:
•The prophylactic, preoperative antibiotic was never
again given on the med-surg unit prior to surgery
unless specifically ordered as such.
•The label used for epidural analgesia was changed
so it was different from that used for other
medications.
•The epidural analgesia box was double checked by
a second nurse before it was closed and whenever
reporting off to another caregiver.
The second case occurred in 2010. It was
a late evening in early June. A husband and wife had
been out to supper together and had consumed seafood,
nothing unusual. The husband began feeling unwell and
was brought to the hospital. The nurse who triaged the
patient (Patient A) determined he was having an allergic
reaction to the seafood he had eaten, which she termed
anaphylaxis.
Thinking a written protocol allowed for and covered
her actions, the nurse administered 0.3 ml of 1:1000
epinephrine subcutaneously. Patient A began to feel better.
A change of shift occurred, and the nurse who triaged the
patient left to go home after giving report to the remaining
nurse. The ED started to get busy and because the ICU
was closed, the ICU nurse was floated to the ED to help.
The nurse who gave the epinephrine at the time Patient
A arrived found herself caring for a patient (Patient B)
with psychiatric needs, a patient who was well known
in the ED and prone to violence. Patient B insisted only
one particular nurse could come into his room. The ICU
nurse reassessed Patient A (with the allergic reaction)
and reported to the physician that Patient A was starting
to feel unwell again. The physician told her to give 3 ml
of epinephrine. The nurse drew up the medication but
was not quite sure about it for some reason she could not
pinpoint. Twice she asked the physician if the dosage was
3 ml of epinephrine and she was told “yes”; in fact, the
physician quickly wrote it down as he was being distracted
by other things. The nurse tried to look up epinephrine
in the drug book and the page was missing. When asked,
the nurse who had given the first dose, said only, “Gee,
that’s a hefty dose,” and continued to talk to Patient B. The
nurse went into the patient’s room and administered 3 ml
of epinephrine, which as you have likely surmised by now,
was a dosage error — 10 times the usual dose.
Within an hour, Patient A had a cardiac arrest. When
reviewing the patient’s chart, the physician recognized
his error. In speaking with Poison Control personnel,
he learned there is no antidote for epinephrine. Autopsy
showed a heart with changes likely caused by epinephrine.
The patient who died was my neighbor; his family,
my friends who were closely associated with the hospital.
I was there with the physicians to talk to this family, to
explain what we thought might have happened and assure
them we would know more after an autopsy. I have the
family’s permission to share this fatal event with you so
that others might be spared a similar event. Also, let
me say that the nurses and physician were experienced
and very competent; they were not prone to or expected
by any of their colleagues to make serious mistakes.
They were personally and professionally devastated
by this occurrence. Although no formal disciplinary
action occurred, this event was examined within our
institution. Consequently, many multiple system issues that
contributed to this devastating error became revealed:
• Although the nurse was experienced in working
with epinephrine, she was accustomed to the dosage
indicated during cardiac arrest, which is more dilute
and used for a different purpose.
•No protocol existed that allowed the nurse to
administer medication for an allergic reaction
without an order.
•Because the patient was medicated prior to being
seen by the physician, the physician never saw
Patient A in his initial condition.
•Having staff attend education sessions and to adhere
to department policies rather than their own posed a
challenge at times.
•The drug books in the ED had not been updated
because the intention was to shift to computerized
resources; education in this area had not been
completed by the ICU nurse by the time of the error.
•Orientation of nursing staff to the ED did not
include anaphylaxis and treatment. Neither was a
checklist included in the Mosby nursing resource
manual used by the facility.
•The epinephrine came in multi-dose vials, a
decision made prior to this event as a way to keep
costs down.
•The nurse felt as though she had “pestered” others
enough even though she remained uncomfortable
with the order. She did not believe she should
continue to question the physician or the other nurse.
What do you think should have happened? Were
these individuals personally and solely responsible for
this patient’s death? Should they have lost their jobs or
licenses? What steps would you take to prevent this sort of
error from happening to anyone else? What lessons do you
take from this occurrence?
Several changes were made as a result of this event, a
few of which included:
•The nurses were informed that in absence of a
protocol for allergic reaction, a physician was
required to evaluate the patient before medication
was given.
•All nursing staff was educated and required to be
proficient in using the computerized resources.
•Epi-pens were supplied for the ED and the multidose
vials were removed from service.
•Anaphylaxis and allergic reaction were added to the
orientation checklist.
•Medical staff and the board of directors approved
a new communication policy of tolerance for
questions from nursing staff and setting forth
ways to assure staff that their questions had been
correctly heard.
The circumstances of this occurrence were truthfully
disclosed to the family, to the hospital personnel, and then
the greater community. In short, the family expressed their
appreciation of the way the situation was handled and
communicated their forgiveness to the nurse and physician
involved. Other far-reaching changes that occurred
included:
•Many hospitals across the country removed
the multi-dose vials of epinephrine from their
emergency departments and replaced them with
Epi-pens, at a cost of $50 per pen compared to
pennies for the multi-dose vial. However, had these
injectables been available to the nurse in the ED, she
would have needed 10 epi-pens to administer the
dose she gave, a signal that would have forced her
continued questioning of such a lethal dose.
•The labeling of epinephrine and the similarity of
appearance of vials with varying dosages was again
brought to the attention of the manufacturer.
•Mosby recognized the gravity of omitting
anaphylaxis treatment from its materials.
Accident
Some holes due to
active failures
HAZARDS
Other holes due to
latent conditions
SUCCESSIVE LAYERS OF DEFENSES
From these two incidents, you can better comprehend
the Swiss Cheese Theory, described by Wachter (2012).
This theory developed by James Reason, a patient safety
expert, posits that the contributing factors to most errors
in complex organizations relate to the organization’s
incomplete layers of protection, which allow the errors to
pass through on their way to causing terrible harm. Thus,
you can see how during simple, everyday tasks we can be
distracted, or give up questioning too easily, or side-step
ingrained procedures. Instead, we all need to be vigilant
every day, all the time, to keep safe the people who trust
us and come to us for help.
Cheryl M. Roberts, BSN, MS, RN, CPHQ teaches
nursing at University of Maine of Fort Kent. She has 30
years of experience in risk management and nursing
administration.
References
Agency for Healthcare Research and Quality. (n.d.). Patient
safety network: Safety culture. Retrieved from: http://psnet.
ahrq.gov/primer.aspx?primerID=5
Allen, S. (2004). With work Dana Farber learns from ’94
mistakes. Boston Globe. Retrieved from: http://www.boston.
com/news/local/articles/2004/11/30/with_work_dana_
farber_learns_from_94_mistakes/?page=full
Institute for Healthcare Improvement. (2006). IHI launches
national campaign to reduce medical harm in U.S.
hospitals, building on its landmark 100,000 lives campaign.
Retrieved from http://www.ihi.org/about/news/Documents/
IHIPressRelease_IHILaunchesCampaigntoReduceHarm_
Dec06.pdf
Institute of Medicine. (2000). To err is human: Building a safer
health system. National Academies Press. Available fulltext
online: http://www.nap.edu/catalog.php?record_id=9728
Institute of Medicine. (2001). Crossing the quality chasm: A new
health system for the 21st century. National Academies Press.
Available fulltext online: http://www.nap.edu/openbook.
php?isbn=0309072808
Wachter, B. (2012). On swiss-chees and patient safety. Wachter’s
World. Retrieved from: http://community.the-hospitalist.
org/2012/06/12/on-swiss-cheese-and-patient-safety/

Page 12 ANA Maine Journal May, June, July 2014
Burnout and the Registered Nurse:
The Implications of Leadership Style
by Denise Worcester, RN
Burnout threatens the health
of nurses and contributes to
workforce shortages (Edward
& Hercelinsky, 2007; Kravits,
McAllister-Black, Grant &
Kirk, 2010). The registered
nurse experiences one of
the highest prevalence rates
of burnout and has been
one of the most studied
professions in this subject area
Denise Worcester
(Leiter & Maslach, 2009).
Therefore, it is fundamentally
important to incorporate strategies that promote a healthy
work environment and professional satisfaction, thereby
diminishing the effects of work-related stressors leading to
burnout. Nursing leadership has an inherent responsibility
to create and maintain healthy work environments, with
leadership style serving as a significant contributing
factor towards this endeavor (Malloy & Penprase, 2010).
This paper explores the impact of (a) burnout on nursing,
(b) distinguishes several styles of nursing leadership (c)
investigates the correlation between various leadership
styles and burnout within the research and (d) reflects upon
potential holistic leadership approaches to address the issue
among registered nurses in the workplace.
Workplace Issue: Burnout
Nursing’s future is challenged by the potential for burnout
that often results from the intrinsic nature of the caring and
healing (Edward & Hercelinsky, 2007). The concept of
burnout was introduced in the 1970s as a way to describe
adverse reactions to work in human services (Kanste,
2008). Burnout is defined as a syndrome of emotional
exhaustion, depersonalization and reduced personal
accomplishment that results from continual exposure to
workplace stressors (Kanste, 2008; Leiter & Maslach, 2009).
Emotional exhaustion can occur from feeling overwhelmed
and emotionally overextended (Fearon & Nicol, 2011).
Depersonalization ensues when nurses lose interest in
their job and the quality of the care they deliver; it is often
referred to as compassion fatigue in the medical community
(Borysenko, 2011). Reduced personal accomplishment arises
from dissatisfaction with achievement and productivity at
work, or simply feeling ineffective in providing the high level
of quality desired in an optimal caring-healing environment
(Fearon & Nicol, 2011). Ultimately, burnout may simply
evolve as a result of the imbalance between what nurses give
and receive in the workplace (Fearon & Nicol, 2011).
Burnout is not only a debilitating condition that
severely affects the health of nurses, but also contributes to
organizational concerns like decreased work performance
and productivity, increased errors, less than optimal patient
outcomes, absenteeism and turnover (Leiter & Maslach,
2009; Milliken, Clements & Tillman, 2007). The incidence
of burnout among nurses in the U.S. has reportedly been as
high as 54 percent with associated costs of an approximated
$250 billion to $300 billion annually (Kravits et al., 2010;
Milliken et al., 2007). An estimated one in five nurses will
actually leave his or her job due to job dissatisfaction and
burnout (Milliken et al., 2007).
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Many factors inherent within the daily demands of the
registered nurse contribute to workplace fatigue, stress, job
dissatisfaction and subsequently burnout. Nursing leadership
style is a factor affording a significant contribution to
the incidence of burnout among nurses in the workplace
(Cummings et al., 2010; Kanste, 2008; Malloy & Penprase,
2010). Whitehead, Weiss and Tappen (2010) identified
leadership as a key source of job stress leading to burnout
through the way managers relate to and communicate with
their staffs. Therefore, nursing leadership has been tasked to
examine its role in bringing health and well-being back to the
nursing workforce through healthier work environments and
improved job satisfaction (Cummings et al., 2010).
Leadership Styles
Definitions of leadership include common key elements:
leadership is a process, leadership involves influence,
leadership occurs within a group setting and leadership
involves pursuit of a shared goal (Cummings et al., 2010;
Whitehead et al., 2010). Successful leadership expands
upon these elements to include concepts such as effective
adaptation, skillful communication, and self-awareness
(Whitehead et al., 2010). There are numerous leadership
styles prevalent in the workplace and often a combination of
styles may be observed in practice to achieve organizational
goals (Cowden, Cummings & Profetto-McGrath, 2011).
Regardless of the particular style, a shared commonality may
be discerned within a task-focused or relationship-focused
framework (Cowden et al., 2011).
Task-Focused Leadership Style
Task-focused leadership focuses on completion of the
necessary tasks within the expectations of the organizational
and unit workflow aimed at achieving certain goals (Cowden
et al., 2011). Task-focused leadership includes transactional
and laissez-faire styles (Cowden et al., 2011; Cummings
et al., 2010). Transactional leadership is characterized by
rewarding achievement and reprimanding mistakes (Malloy
& Penprase, 2010). The reward/reprimand continuum is used
in exchange for follower compliance (Malloy & Penprase,
2010). Alternatively, laissez-faire leadership is a lack of
leadership involving passive management by exception
and avoidance of involvement (Malloy & Penprase, 2010;
Whitehead et al., 2010). Laissez-faire leaders tend to react to
problems only when they become too serious to ignore, and
often avoid situations warranting decisive action (Cummings
et al., 2010).
Relationship-Focused Leadership Style
Relationship-focused leadership focuses on people
and relationships, instead of tasks, to achieve shared
goals (Cummings et al., 2010). Relationship-focused
leadership includes transformational and participative
styles. Transformational leaders motivate others to engage
in problem solving, shared decision making, and their own
professional development through coaching, mentoring and
simply being present (Bjarnason & LaSala, 2011). Ability to
build trust, inspirational motivation, demonstrated integrity,
intellectual stimulation, and individualized consideration are
attributes of the transformational leaders (Kanste, Kyngas,
& Nikkla, 2007; Malloy & Penprase, 2010). This style
demonstrates an ability to communicate a vision in a way
that is meaningful, exciting, and inspires commitment and
The Mission of the Maine Association for Healthcare Quality is
to improve the quality of healthcare by advancing the theory and
practice of quality management in healthcare organizations and to
support the professional growth,
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enthusiasm (Whitehead et al., 2010).
Participative leadership, also known as democratic
leadership, is another relationship-focused style (Whitehead
et al., 2010). This style is characterized by shared leadership
within a team setting and given guidance by a leader
(Whitehead et al., 2010). Important initiatives and decisions
are agreed upon within the team environment (Whitehead et
al., 2010). This style of leadership encourages motivation and
creativity (Whitehead et al., 2010).
Leadership Style and Burnout: The Research
Research has investigated the implication of leadership
style towards the significant workplace issue of burnout
among registered nurses. A distinct relationship emerges,
revealing a correlation between leadership behaviors
and burnout (Cummings et al., 2010; Kanste et al., 2007;
Malloy & Penprase, 2010). Work environments with low
levels of nurse burnout had managers who emphasized the
relational aspects of work, such as individual well-being
and job satisfaction (Kanste, 2008). Alternatively, a taskfocused
leadership style, such as transactional or laissez-faire
leadership, resulted in heightened job dissatisfaction and
burnout (Cummings et al., 2010; Kanste et al., 2007; Malloy
& Penprase, 2010).
A 2008 study surveyed 627 nurses to investigate the
association between leadership behavior and burnout
(Kanste, 2008). Leadership behavior was measured utilizing
the Multifactor Leadership Questionnaire and burnout was
measured with the Maslach Burnout Inventory-Human
Services Survey (Kanste, 2008). The study substantiated
the premise that relationship-focused leadership behaviors,
such as those of transformational leadership, protected
individuals from burnout as defined by emotional exhaustion,
depersonalization and reduced personal accomplishment
(Kanste, 2008).
Another study published in 2009 analyzed the data
obtained from a questionnaire completed by 667 Canadian
nurses (Leiter & Maslach, 2009). The goal was to investigate
the role of burnout in predicting the intention of nurses to
leave their positions (Leiter & Maslach, 2009). Burnout
was measured by the Maslach Burnout Inventory – General
Scale which included the three dimensions of burnout:
exhaustion, depersonalization/cynicism, and inefficacy or
reduced personal accomplishment (Leiter & Maslach, 2009).
The results of this study demonstrated that burnout was a
predictor of turnover intention among nurses surveyed (Leiter
& Maslach, 2009). The study also showed that the primary
reason for turnover was related to the extent to which the
nurses were involved with their work (Leiter & Maslach,
2009). Essentially, the psychological withdrawal of cynicism,
a dimension of burnout, has a direct correlation with social
withdrawal and nursing career choices that include leaving
a position or even the profession in its entirety (Leiter &
Maslach, 2009). This study reinforces the necessity for
nursing leadership to create and maintain a healthy work
environment incorporating optimal leadership style, such as
transformational leadership, that builds relationships, engages
staff, and minimizes depersonalization or cynicism as it
relates to burnout (Leiter & Maslach, 2009).
A Holistic Leadership Approach to Burnout Among
Registered Nurses
The research recognizes the importance of relationshipfocused
behaviors, as an aspect of leadership style, to be
protective measures against burnout within nursing (Kanste,
2008). As such, leadership programs must emphasize an
integrated approach to teaching successful and inspirational
leaders (Wright, 2012). The most important tool a leader
carries in his or her repertoire is the tool of self-awareness
(Wright, 2012). In fact, self-aware, contemplative leaders are
able to recognize the potential for burnout among their staffs
and subsequently take steps to prevent it (Sayre-Adams &
Wright, 2012).
Burnout and the Registered Nurse continued on page 13

May, June, July 2014 ANA Maine Journal Page 13
Burnout and the Registered Nurse continued from page 12
Emotional intelligence is likewise integral to the prevention of burnout (Fearon & Nicol,
2011). Emotional intelligence refers to the ability to process, understand, and manage
emotions with particular emphasis on relationships with others (Fearon & Nicol, 2011). As
a leader, knowing how to handle a situation involves recognizing one’s own feelings along
with understanding the deeper meaning behind those feelings (Fearon & Nicol, 2011). The
use of reflective practices and a holistic approach assists in the development of self-awareness
and emotional intelligence (Fearon & Nicol, 2011). Self-reflection is both a self-care and a
therapeutic clinical practice that integrates the critical thinking abilities of the mind with
the compassion of the heart (Dossey & Keegan, 2013). Emotional intelligence represents the
relationship between emotion and reason, a meshing of the heart and the mind, to create a
caring-healing work environment that reduces the potential for burnout (Akerjordet &
Severinsson, 2010).
Erie Chapman (2011) reflects on seven practices of high purpose leadership within the
book, Radical Loving Care. These practices align with the holistic, relationship-focused
behaviors of the successful nurse leader and include the practices of personal commitment,
passion, the exploration of personal potential, presence, positive attitudes, persistence, and
meditation (Chapman, 2011). These practices are achieved through adoption of a holistic
approach to leadership style involving self-reflection, self-awareness, meditation, and the
development of emotional intelligence (Chapman, 2011; Dossey & Keegan, 2013; Wright,
2012). Chapman speaks of success as being grounded in personal commitment to the
highest possible purpose in our lives (Chapman, 2011). For leaders, this not only involves
a commitment to patient care and optimal patient outcomes, but also a commitment to
staff satisfaction and well-being (Dossey & Keegan, 2013). Passion is a practice of loving
the people with whom we work as well as loving the environment where we are engaged
(Chapman, 2011). Presence requires that we work our way out of our personal needs so
that we may hear and realize the needs of others (Chapman, 2011). Persistence speaks to
the power that motivates us to persevere, even when we may momentarily lose sight of our
purpose, and therefore requires reflection to remind us what is important (Chapman, 2011).
The holistic practice of meditation is essential for self-healing (Chapman, 2011). Allowing
time for contemplation and reflection through meditation practices may enhance healing, and
prevent the risk of incurring new wounds or the inclination to unintentionally wound others
(Chapman, 2011). This speaks to the importance of self-reflective holistic leadership and
emotional intelligence as protective measures against workplace burnout (Dossey & Keegan,
2013; Kanste, 2008).
Conclusion
Burnout is a significant workplace issue affecting the health of nurses and contributes to
a number of organizational issues with substantial financial repercussions. Leadership style
has significant implications for this issue. Leadership development emphasizing relationship
- focused behaviors is essential to the prevention of burnout among our nursing workforce.
Furthermore, holistic approaches incorporating self-reflective practices may assist in the
development of emotional intelligence within the nursing leadership community. With
improved self-awareness, and balance between emotion and reason, nursing leaders will
foster strong relationships with their nursing staffs. Moreover, leadership styles will promote
healthier work environments, and improve job satisfaction and individual well-being.
Leadership may be instrumental in successfully minimizing the effects of burnout inherent in
the caring-healing practices of the nursing profession.
Denise Worcester, RN, is a student at University of Maine at Augusta currently enrolled in
the RN to BSN program. She is a nurse at Maine General Medical Center in Augusta.
Nursing Summit
Student nurses from the University of Maine Augusta (UMA) attending the
Nursing Summit “Nurses Leading Change Through Innovation” on
March 19, 2014 at the Augusta Civic Center. From left: Sophie Starrett,
Allison Maxwell, Maria Goslin, Samantha Healey, Danica Simmons, Trisha
Cote and Jenna Caswell; back row: Shirley Uges.
Picture Credit: Juliana L’Heureux
Fully accredited by the
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University of Maine
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UMA’s RN-BSN program is designed to accommodate
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servings from the Dairy Group
State-of-the-art educational resources
with high-tech Clinical Simulation Program
Learn more about UNE’s MSNA program!
www.une.edu/wchp/sna
GradAdmissions@une.edu | (800) 477-4863 ext. 4225
Visit nationaldairycouncil.org for the latest scientific
research, resources and educational tools.
June is Dairy
Month

Page 14 ANA Maine Journal May, June, July 2014
President’s Message continued from page 1
launched by nursing leaders 100 years ago, has taken an
extraordinary amount of diligence by a committee led
by Ann Sossong, professor of nursing at the University
of Maine in Orono. Among the projects the committee
is engaged in includes meeting with nursing leaders to
record their oral histories and having these interviews
transcribed. Additionally, the committee accessed the
nursing archives at the Maine State Board of Nursing
(MSBON), at the University of Southern Maine (USM)
and at the Boston University Gottlieb Archival Center
and other locations to obtain as many written records
about Maine’s nursing history as possible. A call was
issued in this journal, and at meetings throughout Maine
to ask nurses to submit their stories for the oral and
written history collection. Participating in the nursing
history project with Professor Sossong are nurses Susan
Henderson, Myra Broadway, director of the Maine State
Board of Nursing, Beth Clark, Juliana L’Heureux, Martha
Eastman, Valerie Hart and Marla Davis.
There are 25,000 Maine nurses who will join us for
the Centennial celebrations and our September historic
annual meeting. All of you are cordially invited to our
celebrations!
Looking to make a difference? Come and be
part of our friendly and competent staff.
Are you a recent Registered Nurse Graduate?
Ross Manor, a 93 bed Skilled & Long Term Care
facility, is proud to offer an exciting preceptor program for
recent RN graduates.
We are also seeking dynamic, results-oriented RNs/LPNs
for Full Time and Part Time on our Day and Evening shifts
We have per diem opportunities for
RNs and LPNs on all shifts.
Shift hours are
Days 6:00am to 2:30pm
Evenings 2:00pm to 10:30pm
We offer a comprehensive benefits package for all our full
time positions 30 hours or more including generous earned
benefit time, competitive pay, 401K, Health and Dental
benefits, flexible spending accounts, and voluntary short
term and long term disability.
Please apply in person to
Ross Manor
758 Broadway, Bangor, ME 04401
Or email
hrross@firstatlantic.com
Acadia Hospital is a full service Psychiatric Hospital
located in Bangor, Maine.
Competitive Wages and Benefits offered.
Currently seeking:
For more information about joining our team log on to our website at www.acadiahospital.org.
87th Annual Maine
Safety & Health
Conference
Cross Insurance Center,
Bangor, Maine
For more information call
888-396-2047, Email
check out our website at
www.shcnne.org
Safety & Health Council
of Northern New England

May, June, July 2014 ANA Maine Journal Page 15
Poetry Corner
TAKE HEART
A Conversation in
Poetry
Edited and introduced by Wesley McNair,
Maine Poet Laureate
A short lyric by the late Maine poet David Walker
greets the arrival of a newborn with both praise and
wisdom.
A Prayer, A Welcome
by David Walker
Little wrinkle
from my flesh, eyelid
curling down at my fool’s
prattle; child
State Senator Emily Cain for
US Congress 2nd District
The American Nurses Association
political action committee (PAC) has
endorsed Maine State Senator Emily
Cain of Penobscot District 30. Senator
Cain is running for election to replace
Congressman Mike Michaud who is now a
candidate for governor.
Photo Credit: Juliana L’Heureux
before whom I’m the more
child—your future
older than my past…
Forgive the father
I’ll be, become all
I can never know;
teach me to hold
you for a while, and then
to let go.
Take Heart: A Conversation in Poetry is produced in
collaboration with the Maine Writers & Publishers Alliance.
Poem copyright © 2003 Wesley McNair. Reprinted from
the Maine Poets, Down East Books, 2003, by permission of
Wesley McNair. Questions about submitting to Take Heart
may be directed to Gibson Fay-LeBlanc, Special Consultant
to the Maine Poet Laureate, at mainepoetlaureate@gmail.
com or 207-228-8263. Take Heart: Poems from Maine, an
anthology collecting the first two years of this column, is
now available from Down East Books.
Looking for the perfect
career?
Look no further than...
nursingALD.com
Find the perfect nursing
job for you!
Learn more today!
For more information:
Contact the Office of
Undergraduate Admissions
admissions@une.edu
(800) 477-4863
Earn your BSN
Choose a curriculum that meets
your needs and fits your schedule.
RN to BSN Enrolling Fall 2014
Accelerated Second
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Enrolling Spring 2015
4-Year BSN
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www.une.edu/wchp/nursing
Our state of the art online learning
management system is fully
narrated by a clinical instructor,
self paced and available for
most certifications.
“ALDME”

Page 16 ANA Maine Journal May, June, July 2014
Maine Action Coalition
Strengthening the Future of Nursing in Maine
Get Involved!
www.campaignforaction.org/state/maine
http://www.uma.edu/jean-watson-registration.html
For more information, call (207) 213-2500 or visit
a campus in Augusta, Lewiston, or South Portland.