Newsletter Summer 2010 - the New Mexico Board of Nursing

NursingExcellenceFund SupportsNightingaleScholarshipssummer 2010 • Vol 5 • Number 3The Impact of a NurseResidency Program forNew Mexico

A great nurse can have a great impact on the patients they serve. Memorial Medical Center is lucky tohave a passionate and experienced team of nurses. Many of our nurses, including the ones seen here,have spent over 20 years at MMC caring for the health of our community. We thank all of our nurses fortheir skill and their commitment to the community, and above all—their passion for helping others.Las Cruces, NM • mmclc.org • (575) 521-2230

Contents Summer 2010Message from the Board of NursingChair .............................4Disciplinary Action................7The New Mexico Board ofNursing ..........................8Grounds for Action ...............10Partnerships in NursingEducation .......................12The Impact of a Nurse ResidencyProgram for New Mexico .........13Nursing Excellence Fund SupportsNightingale Scholarships .........15Diversion Program DischargeLetter ...........................16Did you Know?...................17Diversion Program Update ........18New Model for Advanced PracticeNursing .........................21Nursing Practice Act and RulesCurrently in Effectedition 20• NPA, 6-14-91, and 1994, 1995, 1997, 2000, 2005,2006 and 2008 amendments.• Rules 16.12.1 NMAC, Amended 5-17-10The amendments and/or rules are available on ourWeb site or by calling the Board office.Created byPublishing Concepts, Inc.Virginia Robertson, Publishervrobertson@pcipublishing.com14109 Taylor Loop RoadLittle Rock, AR 72223501.221.9986For advertising information contact:Don Grant at 501.221.9986 or 800.561.4686 ext.106dgrant@pcipublishing.comBoard Staff and Direct NumbersDeborah Walker, MSN, RN,Executive Director – 841-9082Cathy Baca, ExecutiveAdministrative Assistant –841-9085Nancy Darbro, Ph.D., APRN,CNS, Diversion ProgramCoordinator – 841-8345Mary Messinger, LADAC, AAS,Diversion Program CaseManager – 841-9091Tani Skinner, BSN, RN,Chief Nurse Investigator –841-9055Daniel Griego, AgencyAdministrator– 841-8344Vicki Vehar, Financial Specialist III –841-9086Shauna Casaus, IT Manager/CIO – 841-9061Ernestine Garcia-Simpson,Advanced Clerk Specialist(Diversion Programs) – 841-9093The New Mexico News & Viewsis published quarterly by the NewMexico State Board of Nursing.Each issue is distributed toevery actively licensed LPN, RN,APN, certified medication aides,and hemodialysis technicians,as well as to nurse employers,and nurse educators. Nurses,students, and professionals fromhealthcare organizations turn tothis publication for updates onclinical practices, informationon government affairs initiatives,to discover what best practicesare being implemented, andfor insight into how healthcareproviders are facing today’schallenges.ContactInformationfor the NewMexico Board ofNursingOFFICIAL PUBLICATION of the NEW MEXICO BOARD of NURSINGMission Statement: “Protect public safety through effective regulation of nursing care and services.”Vision Statement: “Excellence in Regulatory Practice.”Strategic Goals: • Advance Nursing Systems• Maximize Effectiveness in Public Protection• Maximize Effectiveness in Customer ServiceBridget Padilla, Advanced ClerkSpecialist (Criminal BackgroundChecks) – 841-9059Emily Gurule, Advanced ClerkSpecialist (Renewal/Verifications) –841-9089Johnny Romero, AdvancedClerk Specialist (Endorsement/Examination/Advanced Practice) –841-9088Sabrina Vidaurri, Advanced ClerkSpecialist (Discipline/Complaints) –841-9094Laura Moya, Advanced ClerkSpecialist (Unlicensed AssistivePersonnel) – 841-9049Felicia Cordova, Receptionist –841-9056Please continue to call the main numberat (505) 841-8340 or visit ourWeb site: www.bon.state.nm.us to verifylicenses and to check if the nurse’slicense is current. If you need to e-mailus, please click on Contact Form onour home page and then click on thedrop down box and pick whichevercategory you need assistance with.New MexicoNews & Views’circulation includesover 26,000 licensednurses and studentnurses inNew Mexico.Address Change? NameChange? Question?In order to continue uninterrupteddelivery of this magazine, pleasenotify the Board of any change toyour name or address. Thank You.New Mexico Board of Nursing6301 Indian School Rd. N.E., Suite 710Albuquerque, NM 87110phone (505) 841-8340 fax (505) 841-8347Web site: www.bon.state.nm.usBoard MembersPolly Petersen, RN, Secretary –Dona Ana County –Term: 07/01/12Terri Fortner, RN, MSN, PMH-NP,Board Chair – San Juan County –Term: 05/30/11Kathleen Lopez Bushnell,Bernalillo County –Term: 07/01/14Mike Wallace, MSN, FNP-BC,Bernalillo County –Term: 07/01/13Robin Jones, Ed.D, MSN, RN,Vice-Chair – Curry County –Term: 07/01/12Denton Holmes, Public Member –Dona Ana County –Term: 07/01/11Diale Fomukong, M.Sc., CEDFP,Public Member – BernalilloCounty – Term: 07/01/13SubmissionsScholarly and informative itemsdealing with health care topicsand issues are welcome. Contactthe New Mexico State Board ofNursing at the address below.SubscriptionsEach new issue of New MexicoNews & Views is available forviewing on the New MexicoBoard Web site. To request afuture issue to be mailed to you,contact the New Mexico Boardof Nursing at the address below.NursingNews&Views3

National Council ofState Boards of Nursing NewsNCSBN Raises Passing StandardThe National Council of State Boards ofNursing, Inc. (NCSBN) voted on Dec. 10, 2009,to raise the passing standard for the NCLEX-RN Examination. The new passing standard is-0.16 logits on the NCLEX-RN logistic scale,0.05 logits higher than the previous standard of-0.21. The new passing standard will take effecton April 1, 2010, in conjunction with the 2010NCLEX-RN Test Plan.After consideration of all available information,the NCSBN Board of Directors determinedthat safe and effective entry-level RNpractice requires a greater level of knowledge,skills, and abilities than was required in 2007,when NCSBN implemented the current standard.The passing standard was increased inresponse to changes in U.S. health care deliveryand nursing practice that have resulted inthe greater acuity of clients seen by entry-levelRNs.The Board of Directors used multiplesources of information to guide its evaluationand discussion regarding the change in passingstandard. As part of this process, NCSBNconvened an expert panel of nine nurses toperform a criterion-referenced standard settingprocedure. The panel’s findings supported thecreation of a higher passing standard. NCSBNalso considered the results of national surveysof nursing professionals including nursing educators,directors of nursing in acute care settingsand administrators of long-term care facilities.A PDF of the 2010 NCLEX-RN Test Plan isavailable free of charge from the NCSBN Website https://www.ncsbn.org/2010_NCLEX_RN_TestPlan.pdf.The definition of a logit may be found onNCSBN’s Web site at https://www.ncsbn.org/02_18_05_brief.pdf.NCSBN Wants You!: Participate in Item DevelopmentProgramThe National Council Nurse LicensureExaminations (NCLEX®) are designed to testknowledge, skills, and abilities essential to thesafe and effective practice of nursing at the entrylevel. The National Council of State Boardsof Nursing (NCSBN) recruits qualified nursesto serve on NCLEX-RN® and NCLEX-PN® ExaminationItem Writing and Item Review panelswhich are coordinated by the contracted testservice. The process of developing one item(question) for the NCLEX-RN® or NCLEX-PN®examination goes through multiple steps over a12-18 month period and involves many qualifiedvolunteers to write or review items. Thevolunteers who participate on panels are anintegral part of the item development process.The qualifications for the Item DevelopmentProgram are outlined in the following brochure:https://www.ncsbn.org/Item_Development_2009.pdfBenefits to serving on an Item DevelopmentPanel:- All expense paid trip to Chicago.- Contribute to continued excellence in thenursing profession.- Have opportunities to network on a nationallevel.- Build new skills that are useful in your currentposition as well as for professional growth.- Earn continuing education contact hours.If you know of nurses who are qualified tovolunteer, please direct them to our Web siteto submit an on-line application at:https://www.ncsbn.org/1227.htm.NCSBN Publishes 2010 NCLEX-RN DetailedTest PlanThe National Council of State Boards ofNursing (NCSBN) has published the 2010NCLEX-RN Detailed Test Plan and has postedit to its Web site at https://www.ncsbn.org/1287.htm. The purpose of this document, which isoffered in both an Item Writer/Item Reviewer/Nurse Educator version and a Candidate version,is to serve as a guide for both examinationdevelopment and candidate preparation.Based on the test plans, each unique NCLEX-RN Examination reflects the knowledge, skillsand abilities essential for the prospective RN tomeet the needs of clients requiring the promotion,maintenance and restoration of health. TheNCLEX-RN Test Plan is evaluated every threeyears and changes are made based on empiricaldata from a practice analysis, expert judgmentand feedback from member boards. The testplan was approved by the NCSBN DelegateAssembly in August and will go into effect onApril 1, 2010. In addition to the NCLEX-RNExamination, NCSBN also develops and administersthe National Council Licensure Examinationfor Licensed Practical/Vocational Nurses(NCLEX-PN). A total of more than 250,000NCLEX-RN and NCLEX-PN Examinationsare administered each year. More informationabout NCLEX examinations can be found onthe NCSBN Web site www.ncsbn.org, by calling866.293.9600 (toll free) or e-mailing nclexinfo@ncsbn.org.The NCLEX Examination TutorialThe National Council Licensure Examinations(NCLEX) are designed to test the knowledge,skills and abilities essential to safe and effectivepractice of nursing at the entry level. Althoughcandidates who sit for the licensure examinationhave successfully graduated from an accreditednursing program, they still often encounter highlevels of anxiety about taking the examination.In order to dispel the examination fears of candidates,it is helpful to encourage a relaxed approachto the NCLEX examination. One of thebest ways to ensure this is to familiarize oneselfwith the format of the examination by using thefull interactive tutorial available on the PearsonVUE Web site at http://www.pearsonvue.com/nclex/#tutorial. While the content of the tutorialis not nursing centered, it is a beneficial toolfor increasing familiarity with the format of theNCLEX examinations. It is encouraged thatcandidates utilize the tutorial frequently beforetaking the examination. Additionally, candidateswill also complete the tutorial directly beforethe start of their examination at the test center.An awareness of the examination format willprovide a more relaxed examination experi-NursingNews&Views5

ence and allow candidates to concentrate onthe content of the examination.NCSBN Learning ExtensionThe National Council of State Boards ofNursing’s Learning Extension has been relaunchedas a virtual community! Your courseaccess is still only a click away—just go to www.learningext.com and click “Enter Online Campus.”Join the new community in just a feweasy steps: 1. Select the group that is the bestfit for you (Students community, Nurses community,or Faculty community for nurse educators).Set up a profile/add a picture, keep trackof your posts, comments and subscriptions, goto Navigating My Pages (under My Home) tolearn how to use the new capabilities. ContactNCSBN Learning Extension via email atelearning@ncsbn.org; phone at 312.525.3749(M-F 9:00-5:00 CT); or visit the web address:www.learningext.com.Book for foreign educated professionalsA primary resource for foreign-educatedallied health professionals has just been publishedby CGFNS International and SpringerPublishing Company. The Official Guide forForeign-Educated Allied Health Professionals,What You Need to Know About Health Careand the Allied Health Professions in the UnitedNCSBN CEO inducted as a Fellow intothe American Academy of NursingANCC to retire CNSCertification ExamThe American Nurses Credentialing Center(ANCC) will retire the Clinical Nurse SpecialistCore certification examination on July 1, 2010,due to the low candidate volume during theexam pilot window (September 1 – December31, 2009.) Applications for the final cycle of theexam will be accepted from January 1, 2010,through February 15, 2010. Candidates whoapply during this period and are determined eligibleto sit for the exam will be assigned a testingwindow between April 1, 2010, and June 30,2010. Candidates who pass the exam beforeits retirement will receive the credentials CNS-BC. All CNS-BC credential holders will be ableto renew their certification using professionaldevelopment and practice hours on the regularfive-year renewal cycle. Please continue to referto www.nursecredentialing.org/NurseSpecialties/CNSCoreExam.aspxfor additional information,exam applications, cut-off dates, andupdates. Please call our customer service centerat 1.800.284.2378 with any questions. Web address:www.nursecredentialing.org.States provides invaluable insight about providingsafe, competent health care in the UnitedStates. The challenges they face in pursuingtheir dreams to practice in the U.S. range fromleaving their home countries to obtaining a U.S.Please join the Board of Directors (BOD) of theNational Council of State Boards of Nursing (NCSBN®)in congratulating NCSBN CEO Kathy Apple, MS, RN,FAAN, on her induction into the American Academy ofNursing, as a Fellow of the Academy.Kathy was nominated for this prestigious honorby two current Academy Fellows and selected by theAcademy’s 15-member Fellow Selection Committee.Kathy brings more than 34 years of nursing and regulation experience to her position asNCSBN CEO. A few highlights of her career include her selection to serve on the InternationalCouncil of Nurses (ICN) Observatory on Licensure and Registration and being an alumna of theRobert Wood Johnson Foundation Executive Nurse Fellows program.work visa, attaining licensure and employmentin the United States, understanding and communicatingwithin the U.S. health care systemand adjusting to a new life. Based on 30 years ofproviding credentials evaluation and verificationservices pertaining to the education, registrationand licensure of health care professionalsworldwide, CGFNS International teamed withSpringer Publishing Company to publish thisguide for foreign-educated allied health professionalswho seek to practice in the UnitedStates. CGFNS International CEO Barbara L.Nichols, DHL, MS, RN, FAAN, and CGFNSInternational Director of Global Research andTest Administration Catherine R. Davis, PhD,RN, serve as editors for the book. What YouNeed to Know About Health Care and AlliedHealth Professions in the United States is nowavailable online from Springer Publishing athttp://www.springerpub.com/cgfns-allied. Formore information about CGFNS, go to theirweb address at: www.cgfns.org.“Intellectual Disability” in Federal TerminologyA bill introduced in the U.S. Senate wouldreplace the term “mental retardation” with “intellectualdisability” throughout federal health,education and labor statutes. The legislationwould not change the services or rights affordedto individuals, but would merely alterthe federal government’s terminology. Thebill, introduced by Senator Barbara Mikulski(D-MD), and Senator Michael Enzi (R-WY),is named Rosa’s Law after Rosa Marcellinos, agirl from Maryland with an intellectual disability.Some government agencies already use theterm intellectual disability including the Centersfor Disease Control and Prevention (CDC),the World Health Organization (WHO) andthe Committee on Individuals with IntellectualDisabilities, which used to be known as thePresident’s Committee on Mental Retardation(PCMR). A copy of the “Dear Colleague” lettercirculated by Senators Mikulski and Enzi isavailable here: http://mikulski.senate.gov/_pdfs/Press/RosasLawDearColleageLetter.pdf. SenatorMikulski’s full floor statement is here: http://mikulski.senate.gov/Newsroom/PressReleases/record.cfm?id=319975.6 N e w M e x i c o S t a t e B o a r d o f N u r s i n g

Disciplinary ActionsActions Taken June 2010License Number Name Action TakenR43105 Angel Romero Revoke LicenseR24530 Gloria Johnson Stipulated Order/Letter of ReprimandR32776 Zelda Garcia Reinstate LicenseR41919 Christine Dunlap Probation 1 yr/CE Classes/Community Service/FineR64552 Sharon Dixon Continued until June MeetingR44051 Rhonda Lockhart Continued until June MeetingL13594 Susan Granger-Lewis Continued until June MeetingL08273 Elisa Gallegos Continued until June MeetingL20185 Connie Cruse Settlement Agreement/ConditionsR26772/L10488 Belle Betts Settlement Agreement/ConditionsC00255 Nycole Valdez Revoke by Defaultxxx-xx-5604Applicant denied applicationR56901 Josh Jameson Revoke by DefaultR53553 Julie McIlrath Revoke by DefaultH00729 Roby Mathew Revoke by DefaultR37540 Joyce Myers Revoke by DefaultH00635 Angelic Salgado Revoke be DefaultR54955 Brenda Williams Revoke by DefaultR34255 Janis Kercheval Revoke by DefaultIn addition to the above actions, the Board:Authorized the issuance of 15 (fifteen) Notices of Contemplated Action (NCA)Dismissed ten (10) complaintsIssued two (2) Serious Letters of Concern (SLOC)Issued seven (7) Voluntary Letters of Reprimand (VLOR) with fines added to twoSummarily Suspended one (1) licenseTook no action on two (2) complaintsExtended one (1) temporary licenseRescinded one (1) Voluntary Letter of Reprimand (VLOR)Lost or Stolen License/CertificatesLicense Number NAMEL18564R50586R21226Dee Dee DavertAnn BebooyAllin HarleyIn MemoriamR35842L20385R33656Scott PorterLarry DavenportTracy Lynn SchusterNursingNews&Views7

Debra Brady and Nancy Twiggformer Executive Directors for the Board of NursingThe New Mexico Board of NursingThe New Mexico Legislature passed legislation establishing theBoard of Nursing in 1923. Initially, the Board’s focus was onnursing education and the preparation of individual for practice.Legislation passed in 1953 enacted the Nursing Practice Act (NPA) for theprotection of the public, which mandated the Board of Nursing enforce theprovisions of the NPA. Through the years the NPA has been amended tokeep up with the changes in health care and nursing practice, not only inNew Mexico but throughout the United States.Assurance of the safe, competent nursing care and practice nursingregulations involves a commitment by individual nurses to maintain currentknowledge and skills, professional and specialty nursing organizationsstandards of practice consistent with changes in medical and health care,and legal standards/regulations through state legislation. The New MexicoNPA, as well as legislation enacted in other states, establish the minimalrequirements for initial licensure and for maintaining licensure, requirementsfor establishing licensure between states, and authorize boards of nursingto disciplinary action, including revocation of a license, against licensee whois determined to be a potential or actual risk to the public.The New Mexico Board of Nursing functioned as an independentstated agency until July 1986 when the Board along with other regulatoryboards was consolidated into the Regulation and Licensing Department(RLD)and was placed “under the supervision of the Regulation andLicensing Department to streamline and maximize efficiency of stateagencies ” through an Executive Order by Governor Tony Anaya.Taking a look at the history of the New Mexico Board of Nursingand its structure can inform the future and demonstrate thevalue of the services provided under two different regulatorymodels. The Board of Nursing, as an independent agency,underwent many legislative reviews during those years and wasoften recognized as a model for public protection.Taking a look at the history of the New Mexico Board of Nursing and itsstructure can inform the future and demonstrate the value of the servicesprovided under two different regulatory models. The Board of Nursing,as an independent agency, underwent many legislative reviews duringthose years and was often recognized as a model for public protection.In August, 1986, an Executive Order placed the Board of nursing Therationale for this move was administrative efficiency, less bureaucracy,better accountability for outcomes, financial efficiency and reduced costs.Although the Board of Nursing had sufficient staff and finances to carry outthe daily functions and statutory requirements of the NPA, the primarypurpose of consolidating all the board under RLD was to provide smallerboards without sufficient funding with office space or staff to carry out theday to day functions of the board.In April 1988, many nurses in New Mexico and the Board of Nursingbecame concerned with the loss of administrative efficiency in the dailyoperations requested and was granted removal from the RLD. They citedconcern that the Board of Nursing had become less efficient, had moreburecratic layers, less accountability for outcomes and skyrocketing costs.In response to this request, the Governor asked the Board of Nursingto provide documentation that it could meet certain accountabilitystandards. Those standards included accountability to the Governorsuch as notification of all meetings, filing of minutes, regular reports withregard to the operations and management of the board, and compliancewith all statues and laws. Additionally the Department of Finance andAdministration certified the financial independence of the Boardof Nursing and that the Board would not rely on the general fund forappropriation to fund its work. Thirdly the Board presented a staffing planwithin its financial resources which was signed off by the State PersonnelDepartment. The Board presented a plan for a records repositorythat met the State Archives requirements. The Board also generated aschedule for general access by the public during regular business hours. Aplan for handling investigative services and complaints was also provided.In July 1988 an Executive Order was issued that removed the Board ofNursing from the Regulation and Licensing Department.Nursing, as a profession, is responsible and accountable to society for thepractice of nursing. Unlike other occupations, the education and practiceof nursing in this country is constantly changing with the advancementsof technology, medicine, and health care that requires continual changesin regulation of nursing. In order for the citizens of New Mexico to beassured of the same quality of care awarded citizens of other states, theNew Mexico Board of Nursing must continually work with professionaland specialty nursing organizations and other boards of nursing to maintainthe highest standards of nursing education and nursing practice.The New Mexico Board of Nursing is legislative mandated to assurethe citizens have safe and competent care by nurses in New Mexico.Board of Nursing members, like any Board of Directors of a hospital/corporation, must depend on administrators, managers, and support staffhired to efficiently conduct the business of the board day to day. Thatmeans the administrators, managers, and support staff for the Board ofNursing must be completely focused on the business of the Board and thatthe funds obtained through the licensing of nurses must be used efficientlyfor the business of the Board.Our experience as one of the board in RLD resulted in staff beingassigned like duties, such as issuing licenses, among the various boardsthat reduced the efficiency of the staff. Likewise, funds received by the8 N e w M e x i c o S t a t e B o a r d o f N u r s i n g

various boards through the licensing processwere designated for the various operationalduties. Since the Board of Nursing had the mostrevenue, the Board of Nursing was concernedthat nurses’ licensure fees were being used tosupport the operation of other board.According to an Arizona State NursingAssociation Position Paper approved on April14, 2003, the advantages in public protection ofindependent regulatory boards over centralized/consolidated regulatory agencies include:• Administrative efficiency –less layers• Less bureaucracy for the public• Hire staff at the appropriate level and salary• More accountability for regulatory outcomes• Increased ability to make decisions withoutpolitical pressure• Better control by the legislative checks andbalances• Greater accountability, control and allocationof funds and less potential to subsidize otherregulated professions• Reduced cost and cycle times in completinginvestigations as cases do not have to competefor the investigator’s limited time as would beMimbres Memorial Hospital and Nursing Home, located inSouthwestern New Mexico, a 49-bed acute care & a 66-bedSNF/LTC is recruiting for Nurses.NursingNews&Viewsthe case when investigator is investigating lots ofcases from different BONs-CA.State governments interested in conservingresources provide a list of reasons thatconsolidation of Boards is good for the public,including enhanced public service, better supportfor disciplinary services including investigationsand professional administrative support. “Whilestate governments regularly tout superficialadvantages of consolidation, the real drive usuallyis money” (Fiala, 2005). For that reason mostState governments have looked at or haveconsolidated regulatory services of Boards into asingle agency. Boards doing a good job in publicprotection should be asked to demonstrate theirvalue.(Kitch, 2009). Those who are not shouldbe evaluated and recommendations made forwhat should be done.ReferencesFiala, J. (2005, August). State consolidation erodes‘independence’ of licensing board. DVM NewsMagazine.Kitch, M. (2009) Take a harder look at state boards. TheOregonian.We continuously strive to enhance quality of care, valuethe rights and choices of our patients and encouragegenuine care in every contact, every day.Caring People,Caring forPeopleWe are located in the southwestern corner of New Mexico richwith history, atmosphere, sunshine, and many local areas for outdooractivities in abundance.Acute Care and Long Term Care RNsDirector of Nursing • Risk ManagerER Director • Case ManagerExcellent Benefits Package • Competitive SalarySign-On Bonus & Relocation AllowanceNew Mexico participates in the Nursing Compact State Licensing Agreement.If interested, please contact:Johanna R. Gramer, HR Director, Email: johanna_gramer@chs.netor Ramon V. Mejia Jr., RN, Nurse Recruiter, Email: ramon_mejia@chs.netPh: (575) 546-5867 • Fax: (575) 543-6914EOEwww.mimbresmemorial.comReachRecruitRetainNUrsiNgEDUcatioNProgramaPProvalNew mexico statewideFaculty conferenceNursingExcellenceFund SupportsNightingaleScholarshipsDiversion Program UpdateThe New MexicoBoard of NursingJournalto reserve advertising spacecontact Don Grantdgrant@pcipublishing.com1-800-561-4686 ext.106Our nursing journals aremailed directly to over 1.5 millionnurses, healthcare professionalsand educators nationwide.ArizonaArkansasThe Districtof ColumbiaIndianaKentuckyMississippiMontanaNebraskaNevadaNew Mexicosummer 2010 • Vol 5 • Number 3Diversion Program UpdateDid You Know?The Impact of a NurseResidency Program forNew MexicoNorth CarolinaNorth DakotaOhioOregonSouth CarolinaSouth DakotaStuNurse/NationwideTennesseeWashingtonWest VirginiaWyomingThinkNurse.comOFFICIAL PUBLICATION of the NEW MEXICO BOARD of NURSINGMailed to every nursein New Mexico – over 21,000.9

By Tani C. Skinner, BSN, RNGrounds for ActionLegal implications regarding patient care abound, andthe professional nurse, hemodialysis technician, ormedication aide must remain diligent to follow therules and regulations of the Board of Nursing. These rules andregulations, grounded in the Nursing Practice Act, provide thestructure and legal basis to assure the health, safety, and welfareof the public by specifying what actions call for disciplinary action.It is the responsibility of each nurse to read and understandthe Nursing Practice Act as it applies to their own professionalpractice.Two of the most common causes for the Board of Nursingto take disciplinary action include unprofessional conduct andunsafe practice or incompetence. Less commonly, disciplinaryaction may be sought for criminal convictions or convictions ofa felony.Actions considered unprofessional conduct include, but arenot limited to:Many of you have contacted the Board office over the pastrequest to come to work on days off to cover staff illnesses, etc.,or calling in sick according to policy constitutes abandonment.Some of you have reported that you have been threatened witha charge of abandonment if you resign your position.Unprofessional conduct is addressed in the administrativerules of the Nursing Practice Act and includes the followingstatement: Abandoning a patient(s)/clients(s) when theabandonment results or may result in potential or actual harmor danger to the patient(s)/client(s). In considering any complaintciting abandonment, the Board would consider this definition asthe facts of the case are reviewed. Generally, it is the acceptedstandard that abandonment is more likely the issue when a nursehas accepted an assignment within a scheduled work period/shiftand does not fulfill that responsibility or appropriately transferthat responsibility to another qualified person. The core issueof concern to the Board is whether or not the behavior of thenurse on duty placed the patient in an unsafe situation throughher action.At no time is a license automatically removed from a nurse.The Board may consider disciplinary action if the situation doesUnprofessional ConductHarm to the publicFraudDeceitDishonesty in obtaining anursing licenseWorking under the influenceof drugs or alcoholFailing to documentappropriatelyFalsifying or altering clientrecordsMisappropriating money,drugs or propertyInappropriate delegationPractice beyond the scope oflicensureExamples of Unprofessional Conduct.Violating the confidentiality of information or knowledge concerning the patient.Misrepresentation of credentials or experience on applications for employment; Impersonating another licensed practitioner; Impersonatingany applicant, or acting as proxy for the applicant, in any nurse licensure examination.Misrepresenting or falsifying information regarding disciplinary action by the Board of Nursing on an application for employment; Aiding,abetting, assisting or hiring an individual to violate the Nursing Practice Act or rules of the Board of Nursing.Falsifying information regarding former or current disciplinary action by any board of nursing; Falsifying information regarding criminalarrest or felony conviction; Falsifying or altering credentials or training for one’s self or others on applications for licensure or certification.Testing positive for drugs or alcohol on a random drug screen; Testing positive for drugs or alcohol on a pre-employment drug screen;Failing to make or keep accurate, intelligible entries in records as required by law, policy and standards for the practice of nursing.Falsifying or altering timesheets to reflect incorrect information; Falsifying or altering patient assessments; Falsifying dates and times ofnursing care.Receiving money, goods or services that have not been earned; Taking drugs that were not prescribed for the individual taking themedication (including street drugs); Taking money, drugs, or personal property of a patient without authorization;Delegation of medication administration, evaluation and nursing judgment to non-licensed persons.LPNs in a supervisory position over RNs; Administering medications that have not been ordered by a person authorized by law to prescribe;Performing procedures on a patient without medical authorization; Misrepresenting licensure status to a patient.Please see 61-31-28 (A) (6) NMSA, 1978, for a full listing of what constitutes unprofessional conduct.year to ask for clarification about the criteria for “abandonment”.Some nurses relate that supervisors have told them that failureto work an additional shift, failure to comply with a supervisor’smeet the criteria contained in the definition of abandonment.The Board does not take action based upon a recommendationby an employer. Nor can an employer “take” the license of anyContinued on next page10 N e w M e x i c o S t a t e B o a r d o f N u r s i n g

nurse. Even though the supervisor/employermay lodge the complaint with the Board, thefacts of each individual case are reviewed.The definition of unsafe practiceor incompetence is failing to apply theknowledge, skill and care that is ordinarilypossessed and exercised by other nursesof the same licensure status and requiredby the generally accepted standards of theprofession. Allegations of incompetence maybe based on a single act of incompetence,or on a series of acts or omissions. Oftenthese allegations of incompetence arise fromnegligence or medications errors, causingactual or potential harm to a patient.Once investigation into the allegations ofthe complaint is completed, it is up to theBoard to make their decision. Types of rulingsby the Board include dismissal, a serious letterof concern, notice of contemplated action,letter of reprimand, probation, summarysuspension, or revocation of the license orcertificate.If a complaint is filed, you do have rights:• You have the right to have an attorneypresent during the investigation and duringthe hearing.• You have the right to review all of theinvestigative materials and documents priorto a hearing.• You have the right to a transcript of thehearing.• You have the right to have your storyheard.On the Board of Nursing website, http://bon.state.nm.us, nurses, hemodialysis techniciansand medication aides have unlimited accessto the Nursing Practice Act/Rules. Read therules and become familiar with your NursingPractice Act and Rules.Online RN to BSNProgram• Affordable • Flexible• Accessible AnywhereDesigned for the working nurse!CCNE AccreditedA University Worth Discovering!Western New Mexico UniversityInformation: (575) 538-6960 orwww.wnmu.edu/academic/healthscience/nursing/RN2BSN.htmExperience a career at New Mexico’s only Planetree-Affiliate hospital. Come and practice in our uniquetreatment environment where your personal growth isjust as important to us as your professional growth.We are striving to become the workplace of choice inSouthwest New Mexico.Nursing Positions Available at Gila Regional Medical Center• Clinical Coordinator• Emergency Room• Float PoolFor further information contact:Human Resources, 575-538-4675. www.grmc.org1313 East 32nd Street, Silver City, NM 88061• Home Care Services• Med Surg• Nurse Practitioner• NurseryCompetitive salaries commensurate withexperience.Comprehensive benefit package, sign-onbonus and relocation package.Employment is contingent upon successfulcompletion of pre-employment drug andalcohol testing.GRMC is an Equal Opportunity Employer.NursingNews&Views11

Jean Giddens, PhD, RNSarah North, MSErin RogersPartnerships in Nursing EducationNursing education in New Mexico is on themove! Nurse educators from across the statehave recently joined together to form the NewMexico Nursing Education Consortium (NMNEC). The aimof the NMNEC is to transform nursing education across thestate by developing a resource-efficient and unified system ofaccessible, innovative, and state-of-the-art nursing educationthrough a statewide education plan. This consortium followsa national trend for statewide nursing education collaborativesin multiple states, and will address the House Memorial 50legislation recently passed. Working through NMNEC, nurseeducators are committed to building a new model for nursingeducation to meet current and future needs. The challengesfacing nursing education affect nearly every citizen in the state;thus, cooperation of all institutions and organizations is criticalin producing effective solutions.graduate study.2) Improve the efficiency, quality, and educational outcomesof nursing education across the state by utilizing a commoncurriculum plan, sharing faculty, and sharing learning resourcesacross New Mexico nursing schools.3) Increase workforce diversity throughout New Mexico byimproving nursing education access to minorities, particularlyin rural areas.Working through NMNEC, nurse educators arecommitted to building a new model for nursingeducation to meet current and future needs. Thechallenges facing nursing education affect nearlyevery citizen in the state; thus, cooperation of allinstitutions and organizations is critical in producingeffective solutions.Five NMNEC meetings have been held since the group formedin December 2009. Members representing 22 nursing schoolsand organizations from around the state have identified threeprimary goals:1) Increase the number of baccalaureate and graduate preparednurses throughout the state by enhancing pre-licensure BSNeducation and facilitating RN-BSN completion programs.This cooperation among the existing community collegesand universities will allow students to complete baccalaureateeducation within their home communities and be eligible forDuring this year, NMNEC members will be working hard todevelop the statewide nursing education plan in collaborationwith community partners with hopes of implementation in theyears that follow. Consortium members will also be launchinga website and working to develop funding sources; to date,the work of the consortium has been supported in part bya grant from the Robert Wood Johnson Foundation and theNew Mexico Board of Nursing. Upcoming meetings will beheld in July (Gallup), August (Ruidoso), October (Las Vegas),and November (Silver City). For more information about theNMNEC, contact Sarah North, NMNEC Program Manager,University of New Mexico College of Nursing at sfnorth@salud.unm.edu or (505) 272-4125.12 N e w M e x i c o S t a t e B o a r d o f N u r s i n g

Anna von Dielingen, MSN, RNDirector, Professional DevelopmentNew Mexico Center for Nursing ExcellenceThe Impact of a Nurse ResidencyProgram for New MexicoNurses need residencies. This statement is a generalization,but represents the thoughts of many seasoned nurses andnurse leaders across New Mexico and the nation. Thereare many facts which support the need for a transition into practicenurse residency for newly licensed registered nurses. For example,in the next decade a minimum of 50% turnover of the RN workforcewill occur from pending nurse retirees. New graduate nursesare the only source to fill this gap. Current nursing research showsthat, nationally, up to 60% of newly licensed nurses leave their firstjobs within the first year and that nearly 30% of these leave nursingaltogether. The 6 month mark of a newly licensed nurse’s first yearis a critical time when they understand the complexity of nursing andmove into Marlene Kramer’s stage of “shock”! The turnover costsof a newly hired RN average from .75 to 1.25 times an annual salary.Therefore, the cost of losing one new nurse could easily exceed$50,000. A study of healthcare employers revealed that only 42% ofrespondents felt that new graduate RNs were prepared to give safeand effective care. In addition, nursing is a highly complex professionrequiring schools of nursing to “download” a tremendous amount ofinformation to the nursing student. Giving the newly licensed nurseguided entry into this complex field is not only kind and effective, itis essential.Nurse representatives from across New Mexico came togetheras a committee of the Nursing Council of New Mexico (NCoNM),a project facilitated by the New Mexico Center for Nursing Excellence.This committee, Practice and Work Environment (P-WE), wastasked to implement a year long program to guide newly licensednurses with transition into practice. The P-WE committee diligentlycompared several commercially available residency programs (Versant,Vermont Nurses in Partnership, UHC, and the Northwest RuralNurse Residency) prior to selecting the Northwest Rural NurseResidency (NWRNR). The NWRNR is a research project fundedContinued on page 14RN - Unit-Based EducatorsNursingNews&Views50% teaching; 50% treating...and 100% rewarding!If you wish that you could teach in a research-oriented environment and still continueto participate in hands-on clinical care, this could be an ideal opportunity for you.The University of New Mexico Hospitals is looking for qualified RNs in the subspecialtieslisted below to function as Unit Educator and Master Preceptor and to facilitate evidence-basedresearch and also provide direct patient care 50% of the time:CTH Outpatient Clinics (Req# 10828232)Dialysis (Req# 10811018)Trauma/Surgical ICU (Req# 10831838)Operating Room (Req# 10830688)MHC Inpatient Adult Services (Req# 10763767)UNMH is the only teaching hospital in NM. We also have the only Level 1 Trauma Center, and we’re the first in NMto be designated as a Pathway to Excellence Organization. Consumer Reports named us one of the nation’s Top 3hospitals for conservative care; Nursing Professionals magazine rated us among the 2009 Top 100 Hospitals toWork For; and Working Mother magazine calls us one of the 6 Best Companies for Hourly Workers. And now, due tothe standards of excellence among our nursing professionals, we’re currently, confidently pursuing MAGNET status.Requirements for this position include a BSN (or within 6 months of graduation; MSN preferred)along with 3 years of related experience and certification as an Instructor (or obtainedwithin 1 year) in BLS,ILS, NRP, PALS, ACLS and TNCC. You also need NM RN licensure(or as allowed by reciprocal agreement by the State of NM) and CPR certification(or obtained within 30 days of hire).Apply Today! Visit: http://hospitals.unm.edu, click on Jobsand refer to the corresponding Req #.At UNMH everything is attainable. Nothing is out of reach.EOELIST OF SERVICES:BotoxFacial FillersLatisseLaser Hair RemovalPhotofacialUltrasoundPCA Chemical peelsMicrodermabrasionFacialsSPECIAL PRICINGFOR NURSES!!HERE IS AN EXAMPLE OFOUR PACKAGE DEALS:Underarms (reg. $750) $525Upper lip (reg. $480) $336Chin (reg. $600) $420FREE CONSULTATION!Now offering interest FREE financing!4811 Hardware Dr. NEAlbuquerque, NM505-881-4883 • lapielmedispa.com13

Continued from page 21by a Health Resources and Services Administration (HRSA) grant, isevidence based, and follows standards set by the Quality and SafetyEducation for Nurses and National Council of State Boards of Nursing.Since 90% of New Mexico is considered rural this nursing residencyprogram was an excellent fit. This on-line program is offeredto all NM acute and long term care facilities with less than 200 bedsthat are accepting newly licensed registered nurses and have preceptorsto work with them on learning plans. There is no limit to thenumber of residents placed into the program, even if it is only one.The NM Center for Nursing Excellence serves as the clearinghousefor this project. The NM Board of Nursing currently provides financialsupport for this program. The NWRNR is now being offeredas a statewide program called the New Mexico Rural Nurse Residency(NM RNR.) We continue to work closely with the NWRNRand are applying as a collaborative partner for the HRSA extensiongrant. At the conclusion of the year-long program new graduates areexpected to be a competent nurse (using Patricia Benner’s Noviceto Expert framework) and have acquired the confidence and criticalthinking skills necessary for a solid foundation of nursing knowledge.The NM RNR program starts a new session each February, June,Nursing has an opportunity to positively impacthealthcare for residents of New Mexico. Datashows us that 13% of newly licensed nurses lettheir licenses expire within the first 4 years (NMBureau of Business and Economic Research).and September. Here is an overview of the program:• One year on-line program with some classes are given live viaWebEx and others archived and accessible via Moodle. Preceptorsand residents are provided 1 year access to Pepid, a Clinical DecisionSupport System, giving them instant access to diagnoses, medications,nursing interventions, etc.• Preceptors are mentored by NWRNR staff and given 16 hours ofpreceptor training prior to the start of the residency program. Totalnon-clinical time for a preceptor is estimated at 48 hours for theyear. Total non-clinical time for a resident is estimated at 96 hoursfor the year.• At the onset of the program the preceptors and residents conductan extensive competency assessment and create a learning plan forthe resident, providing a foundation for their learning.• Residents have courses every other week for 4 months consistingof 28 hours of core assessment and crisis management in: OB,pediatrics, MS, ER/trauma, psychiatric, gerontology. They have anadditional 36 hours of electives to choose from and may substituteelectives for one of the core courses if the cores are not pertinent totheir practice setting. This is a total of 64 hours of coursework.• During the following 8 months the preceptors and residents operatefrom a workbook and continue on the learning plan with a goalfor the resident to complete the year at the level of competent nurse.Both the preceptor and resident receive a final 16 hour course andcertificate of completion.There is currently no upfront cost for the program outside of preceptortime with the resident and resident training time. High speedinternet access is essential and on-line educational programs mustwork around the firewall systems within healthcare organizations.The June class just got started, and with three facilities participating,10 residents and 11 preceptors are enrolled in the program.Nursing has an opportunity to positively impact healthcare forresidents of New Mexico. Data shows us that 13% of newly licensednurses let their licenses expire within the first 4 years (NM Bureau ofBusiness and Economic Research). According to NM Board of Nursingand HRSA 1000 nursing positions in NM went unfilled in 2008.The NM nursing shortage is projected at 57% for 2020, double thenational rate. NM is 49th of 50 states for the number of nurses topopulation, 600:100,000 (Kaiser Foundation, 2008). Additionally,the NM Con Alma Health Foundation found that New Mexicansliving in rural Hispanic communities face the most significant shortageof health professionals in the nation. Of the 33 counties in NM30 have moderate to severe shortages of health care professionals.This reflects a 90% designation rate as Health Professions ShortageAreas (HPSAs) compared to 25% nationwide.Given these data points and the importance of delivering qualitycare to our NM population, we can’t afford to lose even one newlylicensed registered nurse. We are grateful for the opportunity tooffer our new nurses a transition into practice program which willserve both them as individuals and us as New Mexico citizens.For information on enrollment into the NM Rural Nurse Residencyprogram contact Anna von Dielingen, MSN, RN at 505.889.4518or annavon@nmnursingexcellence.org. Please note, once this programis well rooted and growing we envision offering a similar programfor newly licensed practical nurses.References:Lori Calela; Cheryl Bowles. Recent RN Graduate Perceptions of EducationalPreparation. Nursing Education Perspectives. 2008; 29(5): 266-271.Colleen J. Goode; Mary R. Lynn; Cathleen Krsek; Geraldine d. Bednash. NurseResidency Programs: An Essential Requirement for Nursing. Nursing Economics.2009; 27(3):142-147.Rosemary Pine; Kathryn Tart. Return on Investment: Benefits and Challenges ofa Baccalaureate Nurse Residency Program. Nursing Economics. 2007; 21(5):13-18.J. Smith; L. Crawford. Report of Findings From the 2003 Employers survey. Chicago:National council of State Boards of Nursing; 2004.Nancy Spector; Suling Li. A Regulatory Model on Transitioning Nurses FromEducation to Practice. Journal of Nursing Administration. 2007; 8(1): 19-22.14 N e w M e x i c o S t a t e B o a r d o f N u r s i n g

Nursing Excellence Fund SupportsNightingale ScholarshipsThe New Mexico Board of Nursing approved $25,000to support nursing students across the state throughthe Nightingale Scholarship Program. Hosted by theNew Mexico Center for Nursing Excellence, the NightingaleScholarship Program received over 70 applications representing25 New Mexico communities.Thirteen nursing students were awarded $2,000 scholarships.The Nightingale Home and Hospice Care Scholarship was fundedwith matching contributions from the Board of Nursing and theNew Mexico Association for Home and Hospice Care.The thirteen scholarship awardees are:Practical Nursing:Roy Koehn – Luna Community CollegeKatie Kolosovsky – Luna Community CollegeRobin Pilley – Luna Community CollegeExcellence Funds for scholarships is perfect,” remarked DeborahWalker, MSN, RN, Executive Director of the Board of Nursing.“It represents nurses supporting their future colleagues.”Scholarships were awarded based on academic achievement,an essay written by the applicant on why they have chosennursing as their area of study, and financial need. The impact ofthese scholarships on students furthering their nursing educationhas been expressed in the letters they have sent.“It is my hope that during my future nursing career, I will depictthe values and knowledge that I gain each day here. Thanks toyour generosity, I can continue to learn and grow as a studentAssociate Degree Nursing:Catherine Perez – Luna Community CollegeChristina Vega – NMSU CarlsbadDenise Lovett – Northern New Mexico CollegeBachelor Degree Nursing:Kristen Hanrahan – UNM College of NursingHeather Lauritzen – UNM College of NursingGlenda Allies-Fox – Jacksonville University School of Nursing(online) (Employed at San Juan Regional Medical Center,Farmington)Graduate Nursing (Master and Doctorate)Andrea Zurawski (MSN) – UNM College of NursingJames Rayl (CNP) – UNM College of NursingAnneliese Castillo (MSN) – NMSU School of NursingHome and HospiceNoemi Jauregui – Luna Community CollegeEstablished by the New Mexico Legislature, the NursingExcellence Fund is funded with $5 from every licensure renewalfee. Established as a grant program, the Nursing ExcellenceFund supports initiatives that promote advances in nursingeducation, practice, recruitment and retention. “Using Nursingnurse,” wrote Christina Vega, a student at NMSU Carlsbad.“As I am learning many new skills in a discipline that requiresdemanding schedules, precision and integrity in performance,and high personal expectations, I find myself thriving academicallyand in the field. The assistance of the Nightingale Scholarshipwill make a profound impact on my education,” explained UNMCollege of Nursing student Heather Lauritzen.The selection committee was impressed with the numberand quality of applications this year, “ commented Pat Boyle,Executive Director, NM Center for Nursing Excellence. “Thanksto the commitment and support of the Board of Nursing, wewere able to increase the number of scholarships and the amountof each scholarship awarded. The future of nursing in NewMexico is strong.”NursingNews&Views15

DiversionProgramUpdateDiversion ProgramDischarge LetterNancy Darbro, PhD, RN, LPCC, LADACDP CoordinatorThe Diversion Program was implemented in 1987 so that nurses who have substance use disorders can be monitored for compliancewith abstinence and recovery and continue to verify they are safe practitioners in the workplace. Nurses who have met all therequirements and completed five years of participation and are eligible for discharge must submit a written letter requestingdischarge from the DP. The following, reprinted anonymously with permission from the nurse, is an example of such a letter:Dear Diversion Committee:today I’ll be asking to be discharged from the Diversion Program and after sitting ina meeting of Narcotics Anonymous, I realize the importance of my well being.As I opened my hand and heart at the first AA meeting and accepted the “Justfor Today Book” for the first time, I realized I would need to read and share my personalexperiences in the meetings. Before coming to the Diversion Program, I had thoughtthat just quitting drugs was the road to travel, for some maybe, but not for me. Recoveryin my life is like mending my broken spirit in the operating room of a hospital.I have often heard during and after the meetings that I speak from the heart, and indoing so I’ve accepted the healing process I’d never know before 4 1/2 years ago.I couldn’t have done any of this before then, my miserable life of existence then wasvery dry and intact, much like a dressing on a wound. Just sitting there waiting for thenext dressing change.Only it never got changed until I opened my hand and accepted the fact I needed toget help I didn’t think I needed and didn’t know where to start.But starting anywhere was better than no where. I thank you for showing me thedifference I needed to see, hear, feel and have fondly come to love and accept that selfesteem, self respect and the beauty is not in what you look like, it is in a feeling that Inow have of self worth.I love myself more today than I have ever known and this is a special gift for me, oneof which can not be bought. You can not get this from self medicated moments. It doesn’tcome in a bottle or in the mail.For over four years now you have given me permission to look upward and find myown competence and self work with the direction and support of the Committee andthe Diversion Program. I’ve found what I was missing before entering recovery, and Iwon’t be changing anything. Meetings are important and I will continue to attend regularly.Being of service keeps my recovery possible and I will keep volunteering. Turning itover to power greater than myself is necessary and I will keep doing this as well. Askingfor help and helping new comers are all at the fore front of my recovery.Again I thank each and every one of you sitting where you are in the DP and on thecommittee. You have helped make one more participant make her way up the ladder,through the steps and into a new way of living.16 N e w M e x i c o S t a t e B o a r d o f N u r s i n g

did you know?Keeping Addresses CurrentEvery licensee is responsible for immediatelynotifying the Board office of an address change.Correspondence from the Board such aslicense renewal, applications, notice of disciplinaryproceedings, notice of contemplated action, hearingnotices, and final actions which may affect the licenseare mailed to the last known address of the licensee.Therefore, failure to properly notify the Board officeof one’s current address can result in a lapsed licenseor disciplinary action in the nurse’s absence. Thenurse cannot depend on the postal service to forwardthese. The responsibly rests with the licensee toassure that the Board has a current address on file atall times. There is a form that can be downloaded offour website, and faxed to us.Holy Cross Hospitalin Taos, New Mexicois currently seeking thefollowing positions:ICU/PCU RN, Scrub Tech,ASCU/PACU RN, Med Surg. RNInterested candidates please submitresume to Holy Cross Hospital1397 Weimer Road, Taos, NM 87571or complete an application on-lineat www.taoshospital.org or faxresume to the Human ResourcesDepartment at (575) 751-5784RN to BSN Nursing ProgramNorthern New Mexico CollegeDepartment of Health OccupationsBachelor of Science in Nursing for Registered NursesNorthern New Mexico College Department of Nursing921 Paseo de Oñate | Española, New Mexico 87532www.nnmc.eduPROGRAM DESCRIPTIONThe RN to BSN Program is a unique and innovative programbased upon the Theory of Integral Nursing. TheProgram prepares Registered Nurses to assume leadershiproles as an integral nurse at the bedside, within anorganization, in the community, and in the profession.With an integrative care focus, nurses are prepared toprovide holistic, intentional, relationship-centered carethat addresses individual and collective health. Nursesin the Program are committed to reflective practicethat involves continuous self-assessment and holisticself-care. Faculty view Registered Nurse students asco-learners and colleagues. Adult learning principlesinform teaching and learning strategies.ADMISSION REQUIREMENTSDesigned for Registered Nurses who havecompleted an Associate Degree in Nursing ora Nursing Diploma Program and are licensedto practice in New Mexico or a compact state.129 semester hours of credit are required. 41credits of lower-division courses, to includenursing courses from an Associate Degree inNursing or from a Nursing Diploma Program,will be applied toward the BSN degree. Studentsthen complete 42 credits of upper-divisioncourses. 12 more upper division coursesmust be completed with a Nursing (NURS) orIntegrative Health Studies (IHS) prefix.TO APPLYPlease contact Nina A. Klebanoff, PhD, PMHCNS-BC, APRN, LPCCDirector, RN to BSN Program, Assistant Professornklebanoff@nnmc.edu or 505.747.2278 | FINANCIAL AID: 505.747.2128Online RN to BSNProgram• Affordable • Flexible• Accessible AnywhereDesigned for the working nurse!CCNE AccreditedA University Worth Discovering!Western New Mexico UniversityInformation: (575) 574-5140 orwww.wnmu.edu/academic/healthscience/nursing/RN2BSN.htmNursingNews&Views17

DiversionProgramUpdateCURRENT ADVANCESIN ALTERNATIVE TO DISCIPLINE ANDDISCIPLINE MONITORING PROGRAMSNancy Darbro, PhD, RN, LPCC, LADACDP CoordinatorIt was not until the 1980’s that professional nursingorganizations first addressed the issues of substance usedisorders in the population of nurses. The National Councilof State Boards of Nursing (NCSBN, 1987) and the AmericanNurses Association (ANA,1984) recommended a shift awayfrom the trend of punishing nurses with substance use disordersand toward offering them an opportunity for treatment andrehabilitation. In retrospect, this was the first wave of recognitionand call to action from professional nursing organizations to suggestequal treatment for substance use disorders. This was the beginningof a major shift to ensure that those diagnosed with substance usedisorders should be offered medical intervention and treatmentequitable to those diagnosed with other chronic, relapsing medicalconditions such as diabetes, hypertension and heart disease.Many of you may be aware that in 2009, Congress just passed theaddiction and mental health parity act to counteract the ongoingIn spite of many advances in knowledge andresearch, the common factors of the negativestereotypes and stigma continue to complicatethe picture of intervention and treatment servicesfor nurses with substance use disorders.discrimination and lack of equal treatment for substance use andmental health disorders during the past 30 years.This first movement toward offering a treatment option forrecovery in lieu of punishment for health care professionals withsubstance use disorders was driven by several factors.One was the pervasive negative stereotypes and the deadlystigma that continues to accompany almost any reference toaddiction, addicts, alcoholics, and other terms that refer to thediagnosis of a substance use disorder. The resilience of thisnegative stigma continues to astound those who have worked toeliminate and decrease its power. This stigma continues to deterpeople from seeking treatment for substance use disorders andaddiction. It also deters people from taking the first and necessarystep of acceptance and recognition of a problem with substanceuse disorders.The other factor driving this first call to action was therecognition that while other professions were being offeredidentification and referral services for substance use disorders inthe workplace, no such option was available for nurses and otherhealth care professionals. In addition to the glaring lack of formalresources for nurses was the disturbing statistics that over half ofall disciplinary actions taken by boards of nursing across the nationwere related to substance use and abuse issues (Duke & Zsohar,1995). Regulatory agencies began to implement alternatives todisciplinary action for this percentage of cases where remedialmeasures could address the underlying issues and allow nurses tocorrect and improve their competency to practice.Since that first wave of recognition and calls to action fromprofessional nursing organizations thirty years ago, forty-onestates have implemented alternative to discipline programs toprovide an option for nurses with substance use disorders. Thegoals and responsibilities of these programs are similar andare:1. To protect the public while monitoring nurses to ensure safepractice and adherence to the contractual agreements.2. To encourage the early identification, referral to treatment,and quick entry into a monitoring contract.3. To identify non compliance and report to the board of nursingin a timely fashion.4. To provide education and information to the nursingprofession and community at large to increase knowledge andunderstanding of substance use disorders.Another occurrence since that first wave in the last 30 yearsis that more research has been conducted on all aspects ofsubstance use disorders, including risk & protective factors, signsand symptoms to assist in identification, referral and treatment,return to work guidelines, and screening and brief interventionstrategies to address the massive treatment gap that continues toContinued on next page18 N e w M e x i c o S t a t e B o a r d o f N u r s i n g

exist for these disorders. Both the NationalInstitute of Drug Abuse (NIDA) and theSubstance Abuse and Mental Health ServicesAdministration (SAMHSA) continue to publishextensive research articles on substance usedisorders. Their research can be accessed fromtheir websites. Research has also examinedwhat constitutes the most effective treatmentstrategies that support long term recovery,early identification of relapse, and continuingcare management through the life cycle ofthose recovering from substance use disorders(McKay, 2009: White, 2009).More recent advances in research have alsoextended to reviewing the effectiveness ofalternative to discipline programs in supportingearlier identification and monitoring of physiciansand nurses ( Brown, et al, 2002; Angres, et al,2009). Much of this research has confirmedthat the intensity of monitoring and the closescrutiny of compliance involved with alternativeprograms leads to a higher percentage ofsuccess and more effective outcomes for healthcare professionals (Baldeserri,, 2007; Dupont,et al, 2008: Merlo & Gold, 2008).In spite of many advances in knowledgeand research, the common factors of thenegative stereotypes and stigma continue tocomplicate the picture of intervention andtreatment services for nurses with substanceuse disorders. These factors also contributeto the massive treatment gap that continues toverify that most of those who need treatmentfor substance use disorders will not get it. Infact, 90% of those who need treatment donot recognize the need for treatment, will notaccess any resources for treatment, and willnot be identified by their families, friends orco-workers (Tighe & Saxe, 2006).It has been 30 years since the first call toaction by professional nursing organizations inaddressing substance use disorders in nursing.In addition to the development of alternativeto discipline programs implemented by manystates, most state boards of nursing utilizevarious levels of disciplinary action to addressother violations of the law and rules of theboard of nursing. Often, disciplinary action ismeant to be remedial and corrective, ratherContinued on page 20es inilityRNs, LPNs and CNAsFull-time, part-time and per diemCasa de Oro1005 Lujan Hill Rd., Las CrucesCasa de Sol2905 E. Missouri, Las CrucesEstrella350 E. LaCanada, Avondale, AZLadera5901 Ouray NW, AlbuquerqueLas Palomas8100 Palomas NE, AlbuquerqueMcKinley224 Nizhoni Blvd., GallupMission Arch3200 Mission Arch Dr., RoswellRio Rancho4210 Sabana Grande SE., Rio RanchoSan Juan806 W. Maple, FarmingtonThe Village at Northrise2884 N. Roadrunner Prkwy, Las CrucesKimberly Hauxhurst(559) 297-8509 • fax (505) 468-9306kim.hauxhurst2@sunh.com • www.sunbridgehealthcare.comComprehensive benefits • EOE in drug-free workplacesATTENTION NURSES:Want a flexible scheduleand great benefits?Maxim Healthcare Services is a leadingprovider of medical staffing and homehealthcare services across the nation.Maxim is currently recruiting qualifiedRNs and LPNs to staff local medicalfacilities and homes in New Mexico.Benefits:4 All shifts available4 Same day pay4 Direct deposit4 Generous referralbonuses4 EOECall your local Maxim office today tolearn more about these rewardingopportunities!Albuquerque Homecare (505) 883-4444Albuquerque Staffing (505) 880-0000Las Cruces Homecare (575) 522-8811Las Cruces Staffing (575) 522-0242www.maximnurses.comNursingNews&Views19

than just punitive. To this end, many state boards also utilize disciplinemonitoring programs, which monitor the nurses compliance withdisciplinary orders and public disciplinary action.Because there are several different types of alternative programswith different levels of interactions and accountability to their respectiveboards, it has become clear that there may be a need for furtherresearch into what are the most effective elements of alternativeprograms and how these might be implemented nationwide (NCSBN,2009). The overall rationale for this attention is to continue to providefor the safety and protection of the public, as well as close scrutiny ofcompliance of nurses participating in these programs, and generatingevidence based best practices for these programs.This need to improve the standardization and consistentimplementation of strategies for alternative to discipline and disciplinemonitoring programs has stimulated a second wave of interest anda call for action from national nursing organizations. In view of thesefactors, in the Spring of 2008, the National Council of State Boards ofWe hope that this effort will contribute to the implementationof best practices in alternative to discipline and disciplinemonitoring programs across the nation. At the same time, thiseffort will support the common goals of boards of nursing andalternative to discipline and discipline monitoring programsin protecting the public, offering an option for treatment andrecovery for nurses and ensuring trust and transparencybetween boards and programs.Nursing (NCSBN) appointed the Substance Use Disorder AdvisoryCommittee. The charge of the committee was to review disciplineand alternative programs and provide recommended regulatorypractices for licensees with substance use and abuse disorders. TheNCSBN appointed nine members from diverse backgrounds to staffthis committee. As Chairperson of this committee, I have had thehonor of being involved in the very intensive and extensive work ofthis committee for over two years.Since its inception, the committee has accomplished thefollowing:• Sent out and analyzed a national survey of all current alternative todiscipline programs.• Sent out and analyzed a national survey of all discipline monitoringprograms.• Began to revise and update the Chemical Dependency Handbookfor Nurse Managers.• Developed Model Guidelines for alternative to discipline programsand discipline monitoring programs.• Organized a national Forum to review these Model Guidelines,which was held on April 27 and 28, 2010 in Chicago, Illinois. ThisForum was attended by over 130 participants from across thenation and from every type of alternative program, and generatedlively and productive discussions on the need for Model Guidelinesto guide the future of our programs.The NCSBN committee is reviewing and finalizing the Handbookwhich will include the Model Guidelines as the final chapter. Thetentative title for the new Handbook is “Substance Use Disorders inNursing: A Reference Manual for Alternative and Discipline MonitoringPrograms”. The committee wants to ensure that the most currentand up to date research is being utilized and incorporated into the finalrevisions of all the chapters in the Handbook and the Model Guidelines.We hope that this effort will contribute to the implementation ofbest practices in alternative to discipline and discipline monitoringprograms across the nation. At the same time, this effort will supportthe common goals of boards of nursing and alternative to disciplineand discipline monitoring programs in protecting the public, offeringan option for treatment and recovery for nurses and ensuring trustand transparency between boards and programs. Boards of nursinghave continued to meet their charge to protect the public by utilizingthese alternative to discipline and discipline monitoring programs tomonitor and ensure the safe practice of those nurses with substanceuse disorders.ReferencesAngres, D.H., Bettinaradi-Angres, K, & Cross, W. (2009). Journal of NursingRegulation 1(1), 16-20.Baldiserri, M. (2007). Impaired Healthcare Professionals. Critical Care Medicine,35(2), S106-116.Brown, M., Trinkoff, A., Christen, A. & Dole, E. (2002). Impairment issues for HealthCare professionals: Review and Recommendations. Substance Abuse, 23(3), 155-165.Dupont, R., McLellan, T., White, W., Merlo, L. & Gold, M. (2008). Setting theStandard for recovery: Physician health programs. Journal of Substance AbuseTreatment, 36, 159-171.McKay, J.R. (2009). Continuing care research: what we have learned and where weare going. Journal of Substance Abuse Treatment, 36, 131-145.Merlo,L. 7 Gold, M. (2008). Addiction Research and Treatment. Psychiatric Times,25(6). 52-65.National Council of State Boards of Nursing (NCSBN) (2009). Substance UseDisordersCommittee: National state survey of alternative to discipline programs. Chicago, Ill.Tighe, E. & Saxe, L. (2006). Community-based substance abuse reduction and thegap between treatment need and treatment utilization: Analysis of data fromthe ‘Fighting Back” general population survey. Journal of Drug Issues, 36(2), 165-186.White, W. L. (2009). The Mobilization of community resources to support longtermAddiction recovery. Journal of Substance Abuse Treatment, 36, 146-158.20 N e w M e x i c o S t a t e B o a r d o f N u r s i n g

Susan C. Fox, PhD, RNAssociate Professor, University of NewMexico College of NursingNEW MODEL FOR ADVANCED PRACTICE NURSINGIjust achieved a goal set over ten years ago—taking and passingthe Clinical Nurse Specialist certification examination given bythe American Nurses Credentialing Center. Despite practicingas a CNS for over 5 years and educating CNSs for over 10years, not until national nursing leaders began developing a coherentpolicy for Advanced Practice Nursing did the exam becomeavailable to me.In 2004, the American Association of Colleges of Nursing andNONPF (National Organization of Nurse Practitioner Faculties)called organizations together to consolidate disparate state-tostateand national regulatory and educational practices aroundWe’re lucky in New Mexico. We have less work todo at the state level since our leaders have alreadyfought for title protection, independent practice andprescriptive authority. However, incorporating therecommended changes into rules and law takes atremendous amount of preparation and effort to makecareful and cautions recommendations.the four advanced practice registered nursing roles (APRN)involved in direct patient care—CNS, CNP, CNM, andCRNA. Years of meetings resulted in the Consensus Modelfor APRN Regulation: Licensure, Accreditation, Certification& Education published in July, 2008 and available on theWEB at http://www.aacn.nche.edu/education/pdf/APRNReport.pdf.To date, 48 nursing organizations, including themajor practice groups such as American Academy of NursePractitioners and National Association of Clinical NurseSpecialists, have endorsed the model.Figure 1 depicts the basic structure of the model, showingthe 4 roles at the bottom and population foci in the middle.Individuals pursuing a NP degree would have core coursework for the NP role and then didactic and clinical practicecentered around one of the population focuses. Whengraduated, they would be licensed in the role and populationfocus by their state board. Beyond that, if the nurse specializedin an area such as Cardiovascular Care, Oncology,etc. they could be certified by a professional organization for thatspecialty. The model specifies some aspects of advanced practicemust be consistent –independent practice; independent prescriptiveauthority; agreement of education, licensure and certification;grandfathering for already licensed and certified APRNs; and titleprotection (you can’t call yourself a Nurse Practitioner unless youhave the education and credentialing).The goal of the National Council of State Boards is to havethe model functioning by 2015. Nursing educational institutions(including Doctorate of Nursing Practice (DNP) programs), someState Boards, credentialing organizations, and specialty organizationsare strategizing about how to change their policies and proceduresto bring the model to fruition. At this time, only threestates have implemented the suggested changes in their rulesand law. The Consensus group has established a communicationmechanism called LACE (Licensure, Accreditation, Credentialingand Education) to respond to questions, help build further consensus,and keep nursing talking about the new model and its implications.We’re lucky in New Mexico. We have less work to do at thestate level since our leaders have already fought for title protection,independent practice and prescriptive authority. However,incorporating the recommended changes into rules and law takesContinued on page 22NursingNews&Views21

a tremendous amount of preparation and effort to make carefuland cautions recommendations. New Mexico is in the veryearly stages of this preparation. Universities need to validatethey are teaching to the model which retains the required “3Ps” (pathophysiology, pharmacology, and physical assessment)but changes some scopes to cover the lifespan—these changeswill be required for them to maintain accreditation to teach AdvancedPractice Nursing. Title changes are also proposed, usingthe APRN credential, so credentials may change to APRN-NP andAPRN-CNRA.My credentials were issued as CNS-BC—which I was very happyto receive but may change as the model is enacted. It is hopedthe proposed changes will be advantageous to APRNs—easierendorsement when moving to another state and independentpractice without physician oversight . The model will change thecredential designation for APRNs and may take some time beforeit is accepted by the Nursing profession as well as by the lay public.It has taken time to get the credentials CNP, CRNA, CNS andCNM widely recognized and understood by the consumers ofour services. Hopefully the model will pave the way and allowAPRNs to contribute more fully to delivery of health and illnesscare so badly needed in the State of New Mexico.ADVANCED PRACTICE NURSING: REFERENCESJune 11, 2010Aschenbrener, T. (2010, May 24). The nurse in your health care future.The Oregonion.Campbell, C.D. (2010). Advanced practice. Nursing News & Views, 5(2), 17-18.DeGeest, S., Moon, Pl, Callens, B., Guit, C., Lindpaintner, L., & Spirig,R. (2008). Introducing advanced practice nurses/nurse practitionersin health care systems: A framework for reflection and analysis. SwissMedical Weekly, 138 (43-44), 621-628.Joel, L.A. (Ed.). (2009). Advanced practice nursing: Essentials for roledevelopment (2nd ed.). Philadelphia: F.A. Davis.National Council of State Boards of Nursing. (2008). Consensus model forAPRN regulation: Licensure, accreditation, certification & education.Chicago: Author.http://www.aacn.nche.edu/education/pdf/APRNReport.pdfPearson, L. J. (2010). The Pearson report: A national overview of nursepractitioner legislation and healthcare issues. The American Journalfor Nurse Practitioners, 14 (2), 49-53.Summers, L. (2010). APRN education: A framework for the future. TheAmerican Nurse, 42 (2), 9.Waxman, K.T., & Maxworthy, J. (2010). The doctorate of nursingpractice degree and the nurse executive: The perfect combination.Nurse Leader, 8 (2), 31—33.Targeted NetworkingThe “NEW” ClassifiedsReach every nurse in New Mexico for as little as $200.Contact Don Grantdgrant@pcipublishing.com1-800-561-4686 ext. 106NursingExcellenceFund SupportsNightingaleScholarshipssummer 2010 • Vol 5 • Number 3The Impact of a NurseResidency Program forNew Mexico(575) 538-4875www.grmc.org(505) 272-4578http://hsc.unm.edu/consgSince 2004 helping nurses nationwidesuccessfully challenge the NCLEX-RN ® & PN ®• Recognized Refresher State ofFlorida, State of NM- didacticportion - ONLINE• Prep courses for RN – LPNNew Mexico VAHealth Care Systemwww.albuquerque.va.gov800-465-8262505-265-1711mmclc.org(575) 522-8641WWW.PMI.EDUCall today 561-767-4430http://www.hnsclasses.com575.439.6100www.gcrmc.org22 N e w M e x i c o S t a t e B o a r d o f N u r s i n g

Celebrating Nursing atLea Regional Medical CenterNursing.It’s their purpose. Our reward.Jennifer Ray began 2000Patient Choice Award Winner 2009Benny Thompson, RN began 2006Employee of the Month, April 2009When Lea Regional Medical Center (LRMC) asked former patients tonominate nurses who exceeded expectations, the community respondedwith an incredible number of nominations. The hospital’s Patient ChoiceAward recognizes the exceptional care, comfort and compassion offered bynurses at LRMC, and honors one nurse in particular.As part of the National Nurse’s Week 2009 celebration activities, JenniferRay, RN was presented with the award at the hospital ceremony. Jenniferhas worked for LRMC since 2000. She has worked in a number of areas butall agree she has found her niche in pediatric nursing. Jennifer is a wonderfulteacher to patients, families and her peers. She devotes her nursing skill andcompassion to patients in the hospital and is known to commit personal timelong after discharge.Why would Lea Regional ask former patients to be so involved in spotlightingan exceptional nurse, rather than making the choice internally?“Sometimes it’s just too hard to spot one nurse when there are so manynurses in our hospital doing such an incredible job caring for our patients,”says Melonie Ankerholz, LRMC’s Chief Nursing Officer. “That’s why we areasking our patients to help us make the choice. They see the little things thatmatter so much on a very personal level.”Celebrating nurses at LRMC is a priority. Whether it is as Employee of theMonth, National Nurses week or acknowledging daily nursing successes, wework hard and celebrate often.Debbie Meridyth, LPN began 1998Employee of the Month, May 2009Mary Gonzales began 1996Employee of the Month, August 2009NursingNews&ViewsCall 575.492.5006 orvisit learegional.com foremployment opportunities.5419 N. Lovington Highway • Hobbs, NM575.492.5000learegional.com23

New Mexico State Board of Nursing6301 Indian School Rd. N.E., Suite 710Albuquerque NM 87110PresortedStandardU.S. PostagePAIDLittle Rock, ARPermit No. 1884