Nevada RNFormation – November 2017

November 2017 • Volume 26 • Number 4 

www.nvnurses.org 

Nevada 

RNFORMATION 

Inside 

THE OFFICIAL PUBLICATION OF THE NEVADA NURSES ASSOCIATION 

The Nevada Nurses Association is a constituent member of the American Nurses Association 

Quarterly publication direct mailed to approximately 37,000 Registered Nurses and Licensed Practical Nurses in Nevada 

articles 

4 NNA/NONL Convention 

4 District Reports 

5-6 Legislative Update 

7 East Meets West 

8-9 Dialogues on Diversifying 

Clinical Trials: A Synopsis 

10 Antibiotic Stewardship 

12 Falling Inward 

14 Increasing Breast Cancer 

Awareness 

15 From Dice to Rice 

16 New Academic Practice 

Partnership 

17 Nevada Nurses Foundation 

18 The Mad Hatter’s Big Hat High 

Tea – October 7th, 2017 

18 Nurses Have Talent! 

19 Bleeding Control Training 

19 Membership Application 

regular features 

3 Message from President 

Dave Tyrell 

9 The Grey Muse 

Increasing Breast Cancer Awareness: 

What You Should Know 

Page 14 

East Meets West 

From Dice to Rice 

Page 7 

Page 15 

current resident or 

Presort Standard 

US Postage 

PAID 

Permit #14 

Princeton, MN 

5571 

Mark Your Calendars 

• October 15, NNA Annual Meeting

Page 2 • Nevada RNformation November, December 2017, January 2018 

Have you visited the NNA Job Board recently? 

Visit our website www.nvnurses.org and click on the Job Board 

tab to view many available Nevada nursing jobs. If you want to 

receive email notice when a new job is added, join our Job Board 

mailing list! Just send your email address by text message: 

Text NNAJOBBOARD to 22828 to get started 

or email nnajobs@nvnurses.org. 

If you have a job to advertise, contact Ian at 

nnajobs@nvnurses.org. Our rates are reasonable and 

money raised helps to benefit Nevada nursing. 

www.nvnurses.org 

Published by: 

Arthur L. Davis 

Publishing Agency, Inc. 

NNA Mission Statement 

The Nevada Nurses Association promotes professional nursing 

practice through continuing education, community service, nursing 

leadership, and legislative activities to advocate for improved health 

and high quality health care for citizens of Nevada. 

NNA State Board of Directors 

Dave Tyrell, BSN, RN davetyrellrn@gmail.com ................President 

Donna Miller, RN donnagmiller@flyingicu.com ............Vice-President 

Nicola Aaker, MSN, MPH, RN, CNOR, PHCNS-BC naaker@aol.com ...Treasurer 

Bernadette Longo, PhD, RN longo@unr.edu ................. Secretary 

Heidi Johnston, MSN, RN, CNE heidi.johnston@gbcnv.edu .. Director at Large 

Amy Pang, BSN, RN aepangster@gmail.com ............ Director at Large 

Peggy Lee, BSN, RN lee.peggy4423@gmail.com ......... Director at Large 

Julie Wagner, PhD, RN Julie.wagner9@gmail.com ...... President, District 1 

Dorothy Reynolds, RN, MSN dann1962@hotmail.com ... President, District 3 

Carol Swanson, DNP, RN swansonc89705@msn.com .......Legislative Chair 

Editorial Board 

Editor: Margaret Curley, BSN, RN MCurley@nvnurses.org 

John Buehler Garcia, RN, BSN 

Eliza J. Fountain, RN, BSN 

Wallace J. Henkelman, Ed.D, MSN, RN 

Mary Baker Mackenzie, MSN, RN 

John Malek, PhD, MSN, FNP-C 

Betty Razor, RN, BSN, CWOCN 

Denise Rowe, MSN, RN, FNP-C 

Kathy Ryan, MSN, RN-BC 

Debra Toney, PhD, RN 

Christy Apple Johnson, BSN, RN 

Val Wedler, MSN, RN 

Debra A. Toney, PhD, RN, FAAN, is the recipient 

the 2017 Life Time Achievement Award from the 

National Black Nurses Association (NBNA) for 

outstanding contributions to nursing. Dr. Toney 

is a past president of NBNA and a former board 

member of the Academy. She is the Director 

of Quality Management at Nevada Health 

Centers. Inducted into the Academy in 2007, 

she is on the Quality Health Care Expert Panel. 

Are you interested in submitting an article for publication 

in RNFormation? Please send it in a Word document to us at 

nvnursesassn@mvqn.net. Our Editorial Board will review the article 

and notify you whether it has been accepted for publication. Articles 

for our next edition are due by November 27, 2017. 

If you wish to contact the author of an article published in 

RNFormation, please email us and we will be happy to forward your 

comments. 

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November, December 2017, January 2018 Nevada RNformation • Page 3 

The President’s Corner 

Dave Tyrell, BSN, RN 

President, Nevada Nurses Association 

“Growth is never by mere chance; it is the result of forces working together.” 

–James Cash Penney 

This past quarter was a time of celebration 

for all of NNA membership due to the fact that 

we continue to show significant growth as an 

organization. As we all know the growth of an 

organization does not happen by accident. This 

sustained growth is in direct relation to the 

dedicated forces at work in the North, South 

and Rural areas supporting and promoting NNA’s 

many initiatives throughout this great state and 

beyond. The NNA State Board along with District 

#1 and District#3 would like to thank all of our members, both 

sustained and new, for being such a dynamic force which will insure 

continued growth and influence today, tomorrow and beyond. 

One of the major forces that has contributed mightily to 

helping NNA grow is the Legislative Committee. This group of 

NNA members, lead by Chairperson Carol Swanson has been 

extremely instrumental in getting legislation passed that has had a 

positive impact on healthcare workers and patients throughout the 

state. Along with Carol, I would like to thank the members of the 

Legislative Committee for all of their continued unselfish dedication 

to improving healthcare across the state: 

Amie Ruckman 

Carrie Rowley 

Debra Scott 

Diane McGinnis 

Donna Miller 

Heidi Johnson 

Jean Lyon 

Jeanine Swygman 

Jennifer Brown 

Margaret Curly 

Saundra Hart 

Betty Razor 

Cindy Benardy 

Joanne Heins 

Sheila Story 

Jessica Ferrato 

Thank you all for coming to the table and making a difference! 

On another note, planning continues on the upcoming 2017 NNA/ 

NONL Joint Convention” Creating Our Vision for the Future,” being 

held at the Grand Sierra Resort in Reno, Nevada. The planning 

committee has been working hard for months already, working and 

reworking the agenda to make sure there will 

be something for everyone in attendance. 

If you have not had the chance to sign-up 

to attend as yet you can still go to the NNA 

website to access the link for signing up. I 

look forward to seeing you there. 

If you would like 

to contact NNA or 

President Tyrell, please 

call 775-747-2333 or 

email nna@hdiss.net 

A Message to Las Vegas 

Margaret Curley, BSN, RN | Executive Director, NNA 

NNA is deeply saddened by the recent events in Las Vegas, and 

we recognize the outstanding work of our colleagues in saving so 

many lives. 

Mass casualty situations like this can be hard for everyone 

involved, including health care providers, whether you were at the 

concert or in the hospital. We want to share some advice from the 

National Institute of Mental Health to increase resiliency in avoiding 

PTSD after a traumatic event: 

“Some resilience factors that may reduce the risk of PTSD include: 

• Seeking out support from other people, such as friends and 

family 

• Finding a support group after a traumatic event 

• Learning to feel good about one’s own actions in the face of 

danger 

• Having a positive coping strategy, or a way of getting through 

the bad event and learning from it” 

If you need to talk to someone 24/7, you can always call these 

numbers: 

• Crisis Call Line 1 (800) 273-8255 

• Suicide Prevention Center of Clark County 702 731-2990 

• Suicide Prevention Hotline of Nevada 877 885-4673 

National Institute of Mental Health. (2017, October 2). Post-Traumatic Stress 

Disorder. Retrieved from National Institutes of Health: https://www.nimh. 

nih.gov/health/topics/post-traumatic-stress-disorder-ptsd/index.shtml


NNA D1 Report 

Julie Wagner, PhD, RN 

During times of emergency or 

disaster, Nevadans need your 

health expertise! Visit SERV-NV to 

sign-up as a nurse volunteer to 

assist people and communities 

during their greatest time 

of need. You can sign-up to 

volunteer across the state or 

within your local community. 

Register TODAY at: 

www.servnv.org 

Nevada needs you! 

Your health credentials will be confirmed 

with appropriate State boards and a criminal/ 

sex offender background check conducted 

prior to being accepted as a volunteer. 

Carson, Douglas, Lyon, and 

Storey Counties 

Washoe County 

Clark County 

Funding for this advertisement 

made possible by the Centers for 

Disease Control and Prevention 

(CDC) and the Assistant Secretary for 

Preparedness and Response (ASPR) 

under Cooperative Agreement 

Number NU90TP921907-01-00 

NNA D3 Report 

Mary Bondmass, Director at Large, 

District 3 Board of Directors 

District 3 has been a little quiet for the 

past few months, but that is about to change. 

Plans are being made by the District 3 Board 

to develop a curriculum of continuing nursing 

education courses will be offered online and 

CE credits will be available. The plan is to roll 

out this program shortly after the first of the 

year and to offer CEs to all NNA members at 

no charge. A needs assessment will be sent 

out, so watch for it, and please provide your 

input related to the types of programing that 

is of interest to you. The District 3 board 

realizes that nurses are particularly busy with 

their careers and home lives and going to live 

conferences is not always an option; therefore, 

the Board believes offering online CE activities 

is a responsible way to serve our membership. 

Stay tuned, more to come, and hope to see 

you all in Reno at the NNA Convention. 

As my term as NNA 

District 1 presidency 

comes to a close, I want 

to thank many of the 

professional colleagues 

and members who have 

helped me over the 

last two years to be 

successful to include: 

my District 1 board 

members; the state board members; the 

committee directors; and Margaret Curley, 

NNA Executive Director. Organizations 

can only be successful when members are 

involved. We have increased membership, 

promoted a healthier nursing environment 

and practice, and changed healthcare for 

the better in Nevada due to each of you. 

One of the most important state and 

district goals is to provide professional 

development and education/training, 

which is critical for nurses in shaping the 

future of nursing in Nevada. To this end, 

District 1 has been an active participant 

in the planning of our 2017 Nevada Nurses 

Association & Nevada Organization of 

Nurse Leaders Convention November 

30-December 1 at the Grand Sierra Resort 

in Reno entitled “Creating Our Vision for 

the Future.” I invite each NNA member 

to strongly consider signing up for this 

convention today! 

Supporting the Nevada Nursing 

Foundation with fundraising events and 

awarding educational nursing scholarships 

has been another important goal of 

District 1 and its members. I have been 

appointed this year as a Foundation board 

member and will continue to help raise 

monies for these purposes. 

NNA continues to be the MOST effective 

voice for nursing and healthcare! As 

a professional nurse, I’m encouraging 

each of you to discuss the advantages 

and positive benefits of becoming a NNA 

member. Although we have grown in 

numbers, we need every nurse to be part 

of our collective voice. 

Lastly, I want us each to remember one 

powerful tool that is always available to us 

as nurses going through our life’s journey: 

KINDNESS. The power of kindness brings 

us inner peace and leaves us feeling better 

and happier. Promote your own kindness, 

as it’s contagious to others. Develop 

traits that help promote your kindness to 

include feeling good about yourself and 

respect yourself, give each person your 

undivided attention and listen with respect 

and caring, develop empathy for others, 

give everyone the benefit of the doubt, 

recognize your mood and how it affects 

others, act on your kind thoughts and 

ideas, write others notes of kindness and 

encouragement, and stay connected with 

friends and family. 

Thank you for allowing me to serve 

District 1 and I have enjoyed the 

opportunities we’ve had and in meeting 

such a wonderful group of nurses. I look 

forward to working with our upcoming 

President, Carrie Hintz Rowley to continue 

the goals of the state and district.


Legislative Update 

Jessica Ferrato, NNA Lobbyist 

These last few months have gone by in a 

flash. With session a wrap, the regulatory 

process has started. The legislative interim 

committees have not begun yet, but state 

legislators have submitted their interim 

committee requests to their leadership 

for selection. We will see those selections 

soon and meetings will begin in the 4th 

quarter. We will be watching all healthrelated 

committees and studies for impact 

to the nursing profession and health care in 

general. The Nevada State Nursing Board 

held a handful of meetings and below are 

meeting summaries from two meetings. 

Election season has also started. Many 

people are starting to discuss positions they 

are interested in. Congresswoman Jacky 

Rosen and possibly Congresswoman Dina 

Titus are running against Senator Dean 

Heller. Danny Tarkanian has also launched 

a campaign running for Heller’s seat in 

the primary election. ACA conversations 

were in full swing as congress had many 

attempts to repeal Healthcare reform. Press 

is below and a summary from Clark County 

Commission on the impact to Clark County. 

Health Media Clips: 

Here are some other health related media 

clips from the last few months. 

Uncertainty looms over Nevada’s already 

deficient mental health care https:// 

lasvegassun.com/news/2017/jul/17/ 

uncertainty-looms-over-nevadas-alreadydeficient-m/ 

A brief history of Medicaid in Nevada 

and the people who depend on it https:// 

thenevadaindependent.com/article/a-briefhistory-of-medicaid-in-nevada-and-thepeople-who- 

depend-on-it 

Nevada makes plans for federal grant to 

combat opioid crisis https://lasvegassun. 

com/news/2017/jul/19/nevada-makes-plansfor-federal-grant-to-combat-op/ 

With physician shortages in Nevada, 

Medicaid patients feel acute pain of long 

wait times https://thenevadaindependent. 

com/article/with-physician-shortages-innevada-medicaid-patients-feel- 

acute-painof-long-wait-times 

Legislation to address physician 

shortage finds bipartisan support for 

Nevada congressional delegation https:// 

thenevadaindependent.com/article/ 

legislation-to-address-physician-shortagefinds-bipartisan- 

support-from-nevadascongressional-delegation 

Nevada gets $1.2M grant to fight opioid 

problem https://www.reviewjournal.com/ 

life/health/nevada-gets-1-2m-grant-to-fightopioid-problem/ 

Election Press: 

Election season is already upon us. Below 

you can find press over the last couple 

of months as potential candidates begin 

contemplating which seat to run for. 

3rd Quarter Policy Report 

As potential challengers emerge, Secretary 

of State Barbara Cegavske ‘absolutely running’ 

again https://thenevadaindependent.com/ 

article/as-potential-challengers-emergesecretary-of-state- 

barbara-cegavskeabsolutely-running-again 

Heller, Rosen lead Nevada 

delegation in 2018 fundraising https:// 

thenevadaindependent.com/article/heller- 

rosen-lead-nevada-delegation-in-2017- 

fundraising 

Titus poll: Heller vulnerable in dead heat 

with her https://thenevadaindependent.com/ 

article/titus-poll-heller-vulnerable-in-deadheat-with-her 

Expanding field of Congressional District 

3, candidates gets another challenger – 

former Assemblywoman Victoria Seaman 

https://thenevadaindependent.com/article/ 

expanding-field-of-congressional-district-3- 

candidates-gets- another-challenger-formerassemblywoman-victoria-seaman 

Republican Vegas councilman, former cop 

Stavros Anthony sets sights on Congress 

https://thenevadaindependent.com/article/ 

republican-vegas-councilman-former-copstavros-anthony- 

sets-sights-on-congress 

Nevada’s Dean Heller faces GOP challenge 

from Danny Tarkanian http://www.rgj.com/ 

story/news/politics/2017/08/08/nevadasdean-heller-faces-gop-challenge-dannytarkanian/548218001/ 

Ex-Las Vegas councilman Bob Beers to run 

for state treasurer https://www.reviewjournal. 

com/news/politics-and-government/nevada/ 

ex-las-vegas-councilman-bob- beers-to-runfor-state-treasurer/ 

Recallmania by GOP reveals desperation 

about 2018 map, willingness to subvert 

process https://thenevadaindependent. 

com/article/recallmania-by-gop-revealsdesperation-about-2018-map- 

willingness-tosubvert-process 

Republican state Senate leader Michael 

Roberson jumps into race for lieutenant 

governor https://thenevadaindependent. 

com/article/republican-state-senate-leadermichael-roberson-jumps- 

into-race-forlieutenant-governor 

ACA Conversations 

The ACA was a hot topic through July 

and early August. Below you can find 

a summary regarding a conversation 

Ormsby Post Acute Rehab 

Carson City 

Gardnerville Health and 

Rehabilitation Center 

Gardnerville 

Mountain View Health and 

Rehabilitation Center 

Carson City 

NOW HIRING 

R N s 

& 

L P N s 

For more information, e-mail: jstepanski@empres.com. 

that took place during the Clark County 

Commission July 18. There was a ton of 

press on the decisions that took place in 

congress and between Senator Heller, 

Governor Sandoval and President Trump 

on the impact to Nevada. In summary, the 

Senate failed to compromise enough to get 

a majority of votes to pass the health care 

bill already passed through the House of 

Representatives. Heller supported a motion 

that allowed for debate to go forward with 

a flurry of amendments. The point of this 

process is to find something that passes 

with a majority. That effort failed with 

Senator McCain (R- Arizona) being the final 

“no” vote that stopped all conversations 

before the summer recess. Conversations 

may arise in the coming months as they 

have just returned from the recess but 

there is no certainty. Below you can find 

some media clips. 

Clark County Commission, July 18, 2017 

Commissioner Sisolak previously directed 

the Clark County Commission to have the 

University Medical Center Board of Hospital 

Legislative Update continued on page 6


Legislative Update continued from page 5 

Trustees provide a report to the commission on the impact of a 

potential repeal of the Affordable Care Act and the elimination 

of Medicaid expansion. Presentations were provided from both 

UMC as well as the State of Nevada. Briefly, the presentations 

stated that the ACA reduced the uninsured rate by 42% to 11% 

and added 177,000 patients to Medicaid increasing the statewide 

total to 650,000 Medicaid patients. If the ACA were repealed 

or Medicaid was eliminated, the state would have two options: 

apply for block grants to fill the void or establish a per capita cap. 

The per capita cap would include five categories: aged, blind/ 

disabled, children, expanded adults, and other. The State noted 

that establishing these caps would be easy. However, forecasting 

for these caps would be extremely difficult. Numerous members 

of the public provided comments stating the positive impacts of 

ACA and Medicaid to their lives and their families’ lives. While no 

specific action was taken, the Commission agreed to sign and pass 

a resolution to send to the Nevada congressional delegation. 

Media clips: 

Sandoval, Heller on opposite sides of phasing out state Medicaid 

expansions as part of ACA repeal https://thenevadaindependent. 

com/article/sandoval-heller-on-opposite-sides-of-phasing-out-statemedicaid-expansion-as-part-of-aca-repeal 

With Heller, 5 GOP senators now oppose health bill – enough to 

sink it https://lasvegassun.com/news/2017/jun/23/heller-comesout-against-gop-health-care-bill/ 

Rural Nevada to lose all Obamacare plans next year http:// 

www.rgj.com/story/news/2017/06/28/breaking-prominence-stopoffering-nevada-obamacare- 

plans-january/436730001/ 

Sen. Cortez-Masto denounces Senate health bill at hospital, 

signals support for public option https://thenevadaindependent. 

com/article/sen-cortez-masto-denounces-senate-health-bill-athospital- 

signals-support-for-public-option 

Sandoval is the most important person in the Senate health 

care bill debate https://lasvegassun.com/blogs/elsewhere/2017/ 

jul/15/sandoval-is-the-most-important-person-in-the- senat/ 

Heller says he’ll vote for motion to proceed on Obamacare 

repeal debate https://thenevadaindependent.com/article/hellersays-hell-vote-for-motion-to-proceed-on-obamacare- 

repealdebate 

Heller says he will vote for “skinny repeal” if Medicaid left intact; 

Sandoval signs letter opposing it https://thenevadaindependent. 

com/article/heller-rejects-full-obamacare-repeal-says-he-will-votefor- 

skinny-repeal-if-medicaid-left-intact 

Indy Explains: How Nevada and the rest of the country 

fares under the Graham-Cassidy-Heller proposal https:// 

thenevadaindependent.com/article/indy-explains-how-nevadaand-the-rest-of-the-country- 

fares-under-the-graham-cassidyheller-proposal 

Amodei: Health care not on backburner, NV should form own 

insurance co. http://www.rgj.com/story/news/2017/08/22/amodeihealthcare-aca-obamacare-nevada/588382001/ 

Anthem leaves Nevada health care exchange citing volatile 

market federal uncertainty https://thenevadaindependent.com/ 

article/anthem-leaves-nevada-health-care-exchange-citingvolatile- 

market-federal-uncertainty/ 

Centene will cover Nevada’s rural counties on Obamacare 

exchange https://thenevadaindependent.com/article/centene-willcover-nevadas-rural-counties-on-obamacare- 

exchange 

Nevada State Board of Nursing Committee Meetings 

The board is hosting an APRN update in the north and south 

with the Board of Pharmacy in September; attached you can find 

the flyer. Below you can find two meeting summaries from the 

state board’s committees. 

Education Advisory Committee, 

August 4, 2017 

The Education Advisory Committee had a presentation on 

the regulations around the scope of practice for Medication- 

Aides Certified (MA-C). In the 2011 session, the state legislature 

passed a bill allowing MA-Cs to practice in the state. As always, 

regulations were set in place that outlined their scope of practice. 

The presentation proposed that they change portions of these 

regulation that would affect dispensing of medications and patient 

care processes. 

The presentation also outlined certification requirements as 

follows and provided examples from other states: 

• Read, write, speak and understand English 

• At least 18 years old 

• Free of communicable diseases and in stable physical and 

emotional health to safely administer medications 

• High school graduate or have a GED 

• Employed as a CNA and active on NV Nurse Aide Registry 

• 100 hours of classroom instruction and training specific to 

medication administration 

• 20 hours of returned skills demonstration laboratory 

• 10 hours of clinical experience under direct supervision of 

a licensed nurse in a facility: clinical observation and skills 

demonstration 

• Successful completion of a medication administration exam 

During the presentation, it was emphasized that MA-Cs are a 

solution to the nursing shortage. Nurses will be able to assess 

patients while MA-C administer medication. The presenter 

emphasized 36 other states use MA-Cs and it hasn’t replaced a 

single nurse. Later, she did say that MA-Cs can’t replace nurses if 

there are nurses to take those positions. The presenter discussed 

that MA-Cs also don’t decrease the quality of care and nurses are 

usually happier as they are able to perform their duties as a nurse 

instead of basic tasks that can be managed by a MA-C. It has also 

resulted in a lower incident rate and return to acute rate. MA-Cs 

also provide a stepping stone for CNAs to move to MA-Cs and then 

to RNs. 

They did not have a quorum so they couldn’t vote but they 

anticipate voting at the next meeting to take it to the state board 

for support. 

APRN Advisory Committee, August 1, 2017 

The committee highlighted various bills impacting the nursing 

community from session including passage of POLST, APRN signing 

authority, suicide prevention and the committee for caregivers in 

group homes. 

There will be a full legislative update from the state board open 

to the public and all nurses on Sept. 22 in the south and Sept. 29 

in the north. The locations can only hold 125-150 people so it’s first 

come first serve. I can send more information if needed. 

The committee also talked about implementation of suicide 

prevention credits from the session. APRNs need to complete 

two hours of suicide prevention and awareness training worth 

2 CE every four years. The Suicide Prevention Resource Center 

offer a free training at training.sprc.org. The Nevada Psychiatric 

Association has a training available and it was mentioned that the 

NNA is creating a training as well.


“No matter the culture or language barriers, people are 

all generally the same in their desires for health, safety and 

happiness,” stated Dr. Tracey Long who traveled to Southern 

China this summer and learned more about Chinese Medicine. 

How people achieve those goals however, varies in approach and 

practice. 

In contrast to the American model of corporate medical 

insurance and Government programs of Medicare and Medicaid 

as the main payer for medical services, China’s medical system 

is mainly socialized medicine. In mainland China, government 

health insurance is mandated for a nominal monthly cost, 

however the coverage is limited to minor health issues seen 

in doctor visits for common acute health complaints such as 

colds and coughs. The government will not cover medical bills 

for chronic health disease management such as diabetes, 

hypertension, coronary artery disease or cancer, the most 

common diseases seen in the United States. The general attitude 

by people, however, is that they won’t pay for the government 

insurance because it won’t pay for their medical needs, so 

they end up purchasing private insurance anyway. Similarly, 

Americans are also currently dealing with the dilemma of how to 

balance mandated government minimal essential coverage, and 

the limitation of what it will and will not cover. Likewise, both 

American and Chinese individuals can choose a private insurance 

company at their own expense to expand medical coverage, 

especially for chronic disease management. 

There are different health issues in the US compared to 

China. Hypertension, diabetes, metabolism syndrome and 

coronary artery disease are more common in the US than in 

China. Overweight and obesity, which are the dominate lifestyle 

diseases by Americans are generally not seen in China in the 

high prevalence statistics seen in the US. In contrast, the 

smoking population is greater in China than in the US, with its 

result of COPD. The dietary habits of the Chinese consist mainly 

of rice, vegetables and lean meats and fish with very rare intake 

of dairy, wheat and sugar, and are in sharp contrast to the high 

fat, sugar, corn and wheat diet of Americans, which contributes 

to our American obesity and diabetes epidemics. 

Interestingly, western medicine is practiced and taught in 

Chinese medical schools and only 10% of all hospitals even offer 

Traditional Chinese Medicine. “Only older people and remote 

villages without access to modern hospitals will still practice 

traditional Chinese medicine” stated Ian Yi, a 3rd year medical 

student from Shenzhen, China. China has modeled their medical 

East Meets West 

system by the Western model and although teas and herbs may 

still be used by the general population, they diagnose and treat 

disease with an allopathic approach. China is an interesting blend 

of both modern and ancient practices as millennial-old folk and 

Buddhist practices are combined with modern technology. People 

can be seen going into traditional temples lighting incense with 

one hand as they navigate their smart phone with the other. 

To become a nurse in China, school is only two years after 

high school plus one year as an internship in a hospital and then 

a required board certification for licensure. Most nurses will work 

in hospitals, as private ventures are not as common or easy. 

To become a physician in China, schooling is 4 years of medical 

school after high school, plus an internship and residency of 6-8 

years depending on specialty before they can qualify to take 

the National Medical Licensing Examination (NMLE). Nurses and 

doctors are all government workers for the Ministry of Health 

and the general salary for a nurse is approximately $1000 US/ 

month. A physician may earn more between $3,000 and $4,000/ 

month depending on specialty and profits from drug sales, 

bonuses and even “red envelopes” of gifts from patients. A red 

envelope is an extra payment from a patient to a doctor as a gift 

or enticement for better care, which is now considered illegal in 

China. Physicians are considered middle class and not at the top 

tier of society, unlike the high esteem for doctors and nurses 

seen in the US. Nursing does not enjoy the respectful reputation 

compared to the US and they do not have the Nurse Practitioner 

or Advanced Practice Nurse specialties. The nurse role is still 

considered to be the “handmaiden of the doctor” in China. A 

teacher is more highly regarded than a nurse. “Teachers give 

you knowledge and doctors save your life but nurses just do the 

dirty work” mused Rosa Chang, a business woman in Shenzhen. 

Dr. Long was able to travel under the sponsoring company 

Wrightway International, who is hoping to develop a partnership 

with Nevada nurses and nursing students who want to learn 

about Chinese Medicine first hand in China. For more information 

and to be part of a service medical trip to China in 2018 please 

contact Dr. Tracey Long at longforhome@gmail.com.


Dialogues on Diversifying Clinical Trials: A Synopsis 

Mary Ellen Taylor, MSPH, Health Communications Specialist, Office of Regulatory Affairs 

Office of Communications and Quality Program Management U.S. Food and Drug Administration 

The FDA Office of Women’s Health, Society 

for Women’s Health Research (SWHR) and 

the FDA Office of Minority Health held a 

meeting - “Dialogues on Diversifying Clinical 

Trials” - to address the need for greater 

representation of women and minority 

groups in the development of medical 

products. 

Patients, clinicians and representatives 

from the pharmaceutical/biotechnology 

industry, academia, advocacy groups, and 

government agencies attended and discussed 

how to improve recruitment and retention 

of women and minorities, communitybased 

approaches to clinical trial design, 

and federal perspectives on guidelines and 

regulations to improve diversity in research. 

Well-established differences in incidence 

of disease between the sexes and among 

racial or ethnic groups exist. Diseases that 

disproportionately affect ethnic minorities 

include: type 2 diabetes, cardiovascular 

disease, stroke, infectious diseases (HIV/ 

AIDS, STDs), and cancers (colon, prostate, 

cervix, lung). Some of the variations result 

from genetic variants that are more common 

in certain subpopulations than others. 

Lifestyle and socioeconomic factors influence 

risk bias based on sex or race/ethnicity. 

For instance, women live longer and bear 

greater disease burden than men, and ethnic 

minority groups are disproportionately 

affected by poverty and low socioeconomic 

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status, which are linked to poorer health 

outcomes. 1 

Many racial health disparities stem from 

lack of access to quality health care and 

proper health awareness. 2 This means that 

incidence of disease does not always match 

trial populations. 

• African-Americans* represent 12% 

of the U.S. population but only 5% of 

clinical trial participants. 3 

• Hispanics make up 16% of the 

population but only 1% of clinical trial 

participants. 4 

• Sex distribution in cardiovascular 

device trials is 67% male. 5 

The Coalition to Eliminate Disparities 

and to Research Inclusion in Clinical Trials 

(CEDRICT) identified minority lack of 

disease education as a major barrier to 

recruitment. Other significant barriers 

to diversify enrollment, are insurance, 

patient inconvenience costs, transportation, 

distance to the study site, and patient 

and family concerns about risk. Race, 

age, and sex have been shown to play 

more significant roles in trial participation 

compared to proximity to trial location. 6 

There are negative attitudes toward 

medical research that prevent patients from 

enrolling, but similar negativity is present in 

industry. From the sponsors’ perspective: 

• Women and minority patients are 

more difficult to recruit. 

• Women and minority physicians have 

less experience and are relatively 

more costly to engage. 

• Minority patients with limited English 

proficiency can require costly 

translation services. 

NIH-funded studies have specific diversity 

requirements. Currently, there are FDA 

recommendations, but no regulations in 

place to require industry sponsors to include 

women and minorities in clinical trials. 

Diversity is not a natural priority for industry, 

where decisions often are made by market 

attractiveness and potential for profit. 

Sex differences are observed in response 

to many drugs. 7 Females have a 1.5 to 1.7 

fold greater risk of developing an adverse 

drug reaction, and several drugs have 

been withdrawn from the market over the 

last two decades for sex-based adverse 

events. 8 Medical devices are particularly 

subject to gender bias, based on the 

significant physical differences between 

men and women. With regard to race 

and ethnicity, a number of studies have 

found variations in drug metabolism and 

toxicity in chemotherapy, 9 antiretroviral 

agents, 10 immunosuppressant drugs, 11 and 

cardiovascular medications. 12 

Several successful strategies were explored: 

Recruit Female and Minority Physicians – 

The first step to engage women and minorities 

is finding them. Research has shown that 

minority patients seek physicians of their 

own race, so bringing these doctors into 

trials is critical. 

Build Trust through Communication – 

Sponsors must demonstrate the importance 

of the trial and the potential benefits for 

the patient and his/her community through 

transparent communication using cultural 

sensitivity. 

Educate to Raise Awareness - Patients 

must be empowered to demand quality 

healthcare, and the needed information to 

make their own decisions about treatment. 

Physicians must be aware of trials and 

fully recognize sex or race/ethnicitybased 

differences in disease prevalence or 

symptoms. 

Involve Communities - Utilize communitybased 

participatory research to build trust, 

educate patients, and raise awareness. New 

paths to diversity have been developed by 

eliciting the support of trusted community 

leaders. 

Recommendations include: reexamining 

trial design and ethics, fostering multisector 

collaborations, incorporating new 

technologies, adapting to the changing 

face of medical research, and increasing 

efficiency in regulation and review. To 

read the report, see: https://www.fda.gov/ 

downloads/scienceresearch/specialtopics/ 

womenshealthresearch/ucm334959.pdf 

1 American Psychological Association. “Socioeconomic 

Status and Health Fact Sheet”. Washington, 

D.C.: American Psychological Association; 2011. 

Available from: http://www.apa.org/about/gr/issues/ 

socioeconomic/ses-health.aspx. [Accessed: 2011 Nov 

8]. 

2 Thomas S. B. and Quinn S. C. Poverty and Elimination 

of Urban Health Disparities. Ann NY Acad Sci. 2008; 

1136(1):111-25. 

3 Data presented by P. Sanders in “Dialogues on 

Diversifying Clinical Trials,” Washington, D.C., 2011 Sept 

22. 

4 Data presented by J. Tierney in “Dialogues on 

Diversifying Clinical Trials,” Washington, D.C., 2011 

Sept 22. http://www.womenshealthresearch.org/site/ 

PageServer?pagename=events_clinicaltrials. 

5 Dhruva S. S., et al. Gender Bias in Studies for Food 

and Drug Administration Premarket Approval of 

Cardiovascular Devices. Circulation: Cardiovascular 

Quality and Outcomes. 2011 Mar 1; 4(2):165-71. 

6 Kanarek N. F., et al. Geographic proximity and racial 

disparities in cancer clinical trial participation. J Natl 

Compr Canc Netw. 2010 Dec; 8(12):1343-51. 

7 Anderson G. D. Sex and racial differences in 

pharmacological response: where is the evidence? 

Pharmacogenetics, pharmacokinetics, and 

pharmacodynamics. J Women’s Health. 2005; 14(1):19- 

29. 

8 Zopf Y., et al. Women encounter ADRs more often than 

do men. Eur J Clin Pharmacol. 2008; 64(10):999-1004. 

9 Phan V. H., et al. Ethnic differences in drug metabolism 

and toxicity from chemotherapy. Exp Op Drug Metab 

Toxicol. 2009; 5(3):243-57. 

10 Rotger M., et al. Genetics, Ethnic and Gender 

Differences in the Pharmacokinetics of antiretrovival 

agents. Curr HIV/AIDS Rep. 2006 Sept; 3(3):118-25. 

11 Dirks N. L., et al. Pharmacokinetics of 

immunosuppressants: a perspective on ethnic 

differences. Int J Clin Pharacol Ther. 2004 Dec; 

42(12):701-18. 

12 Schaefer B. M., et al. Gender, ethnicity and genetics in 

cardiovascular disease: Part 1: Basic principles. Heart 

Dis. 2003 Mar-Apr; 5(2):129-43.


Example of labeling changes due to racial diversity. 

For a toolkit provided to promote diverse women’s participation in clinical trials, visit: www.fda.gov/womeninclinicaltrials. 

For additional information on minorities and clinical trials, visit: https://www.fda.gov/ForConsumers/ByAudience/MinorityHealth/ucm472295.htm 

The Grey Muse: The Cost of Growing Old 

Val Wedler, MSN, RN 

According to recent 

statistics on aging and 

health, most of us can 

expect to outlive our 

parents by at least 10 

years (Centers for Disease 

Prevention and Control, 

2016). My mother will 

be celebrating her 90th 

birthday in a few days, 

and although she is in the advanced stages 

of dementia, physically she is very healthy. 

Longevity runs in my family on both sides. 

My maternal grandmother lived until just 

before her 97th birthday and my paternal 

grandmother died in her late 80’s. Based on 

these statistics and our family genetics, I 

could possibly live into the triple digits. Oh my! 

Director Richard J. Hodes, of the National 

Institute on Aging (NIA), reports that although 

people are living longer, it does not necessarily 

mean that they are living healthier (Hodes, 

2015), which begs the question,” Why not?” 

Unfortunately, the answer is not that simple. 

The NIA study mentioned above compared 

baby boomers in the 51-56 age bracket to 

those in the same age group a generation 

ago and found that today’s group suffered 

from more health problems than those of a 

similar age in the past, including an increase 

in diabetes, heart disease, mobility problems, 

and obesity. “This may be due to the more 

sedentary lifestyle that is prevalent today, but 

it certainly does not bode well for the future 

if we have a population that is living longer 

but with more chronic health conditions. The 

system could be stretched to a breaking point 

as a result” (Hodes, 2015). 

In his report, Hodges suggests that there 

are only so many resources allocated to the 

healthcare system at the moment, the same 

resources that are being stretched by a sick 

and aging population. Hodges believes that 

eventually many of these individuals are 

going to be left with nowhere to go as Social 

Security and Medicare funding disappears 

completely (Hodges, 2015). “Bed shortages, 

delays in emergency response time, a lack of 

providers, and even the end of Medicare as 

we know it is hovering on the horizon for our 

aging population” (Hodges, 2015). 

Social Security pays out retirement funds 

for over 44 million older adults each year 

according to the US Government Trustees. At 

the current rate of depletion, all funds will be 

gone by the year 2035. Medicare also, has a 

bleak future outlook. Funding for Medicare is 

expected to run out by 2024 if no alternate 

source of funding can be found to carry it 

forward. “If the population continues to grow 

as it has done within the last two decades, and 

people continue to live longer with no means 

to support themselves or pay for healthcare, 

the nation could be put into a very serious 

crisis within the next 15 – 20 years” (Hodges, 

2015). Pretty scary stuff if you ask me. 

Currently, my mother is happy and well 

cared for in memory care facility. Since she 

does not qualify for Medicaid, she pays for all 

her living expenses out of pocket, which are 

considerable. She receives a small benefit 

from Social Security each month which helps 

to defray these costs and luckily, Medicare 

and her supplemental insurance have been 

able to cover her medical bills without a 

substantial drain on her finances. She is one 

of the lucky ones. She will not live to see the 

demise of her Social Security benefits or the 

absence of Medicare in her lifetime. But I will, 

and knowing what is likely to happen gives 

me great cause me for concern. Not only for 

myself, but for the rest of my generation and 

all the other generations, who through their 

longevity, will be destined to follow in our 

footsteps. 

The Grey Muse 

References 

http://www.examiner.com/article/baby-boomersdon-t-be-a-health-crisis 

http://www.businessweek.com/news/2012-04- 

23/social-security-fund-to-run-out-in-2035- 

trustees-say


Antibiotic Stewardship 

A Day of Antibiotic Stewardship 

By Norman Wright, RN, BSN, MS 

Over 100 health 

care professionals 

participated in the 

Nevada Antimicrobial 

Stewardship Program’s 

third annual infection 

prevention caucus held 

simultaneously both in 

Reno and Las Vegas. This 

year’s theme was: “The 

Evolution of Antibiotics: Misuse Yesterday + 

Resistance Today = No Choices Tomorrow.” 

The event co-sponsored by the Nevada Office 

of Public Health Informatics and Epidemiology 

(OPHIE) and HealthInsight focused on 

establishing new antibiotic treatment 

methodologies at the facility level to address 

the growing problem of Antibiotic Resistance. 

The day began with Zuen Qui-Shultz 

MPH, CPH from the Southern Nevada Health 

District, who defined an antibiogram as 

an overall profile of the various pathogens 

susceptible to a panel of various antibiotics 

designed to provide prescribers with the best 

antibiotic options based on resistance patterns 

in a given geographical area. She then 

discussed the 2016 Clark County Antibiogram 

and gave this website to review it in detail: 

http://www.southernnevadahealthdistrict.org/ 

stats-reports/antibiogram/#/ 

Chris Marchand, MPH, reviewed the 

University of Nevada at Reno, School of 

Medicine’s – “Project ECHO Nevada” – 

ECHO uses a telehealth linkage to connect 

university-based medical faculty specialists 

to primary care providers in rural and underserved 

urban areas to extend specialty care 

to patients with chronic, costly, and complex 

medical illnesses. Information is found at: 

https://med.unr.edu/echo 

It is impossible to summarize the one hour 

presentation that Diane H. Rhee, Pharm D, 

MHA gave in one paragraph, but briefly it 

focused on C-difficile, how the hyper-virulent 

BI/NAP1/027 strain is in Southern Nevada and 

how it does not respond well to traditional 

treatment. She reported the NAP1 strain, 

which produces more poisonous toxins than 

prior C-diff strains, does not respond well to 

Flagyl, and also raised concerns with use of 

Vancomycin that increases the prevalence 

of VRE. Use of other, expensive, antibiotic 

treatments including Fidaxomicin is not 

effective against the BI/NAP1/027 strain. She 

reviewed the benefits of, and recommended, 

fecal transplant over antibiotic therapy which 

she reports is both more cost effective and 

has reduced the incidence of recurrent C-diff 

infection. 

The morning session concluded with Dr. 

Jerry Reeves, MD, HealthInsight Corporate 

Vice President of Medical Affairs, who 

discussed Outpatient Stewardship. He 

cited that sixty-two percent of antibiotic 

expenditures are in the outpatient setting 

and 30% to 50% of outpatient antibiotics are 

inappropriately prescribed, are not needed 

in the first place, and/or the wrong antibiotic 

/ dose / duration was prescribed. Dr. Reeves 

highlighted the fact that antibiotics are a 

multi-billion dollar business and the financial 

costs continue to expand. Dr. Reeves 

promoted the CDC’s “Get Smart: Preserve 

the Power of Antibiotics” campaign and the 

companion CDC initiative “Core Elements of 

Antibiotic Stewardship.” Additional details of 

the program can be found at: https://www. 

cdc.gov/getsmart/community/index.html 

After lunch Kimberly D. Leuthner, PharmD, 

FIDSA gave a powerful presentation on the 

appropriate length of time that antibiotics 

should be prescribed for. Dr. Leuthner began 

her presentation by saying, “It Depends” and 

expanded on that by stating that prescription 

duration should be disease specific and 

contingent on individual patient response. 

Various studies show present prescribing 

patterns generally are excessive and that 8 

days of antibiotic therapy have a cure rate as 

effective as 15 days of antibiotic treatment 

for ventilator associated pneumonia (VAP). 

Other infections including intra-abdominal 

infections and pyelonephritis also show “no 

difference in outcomes with short course 

treatment” and that shorter duration 

times were just as effective as the current 

traditional lengthy antibiotic prescribing 

patterns of physicians, NP’s and PA’s. The 

conclusion was shorter courses of antibiotic 

therapy are not only as effective but the 

shorter treatment times also reduces 

antibiotic resistance and preserves the power 

of antibiotics. 

Donna S. Thorson, MS, CPHQ, CPPS 

from HealthInsight presented “Antibiotic 

Stewardship in the Nursing Home.” New 

Long Term Care mandates are being 

initiated including a new F-tag, F-881, 

which mandates Skilled Nursing Facilities 

to develop an antibiotic stewardship 

program that requires the participation 

of the physician, pharmacist, nursing and 

administrative leadership. Ms. Thorson 

reviewed steps to start a stewardship 

program in the LTC setting. The programs 

include the CDC Core Elements of 

Stewardship, antibiotic tracking, use of 

antibiograms, and other elements. Nursing 

homes are required to have an antibiotic 

stewardship program in place by November 

28, 2017. Another new F-tag; F-757 

“unnecessary drugs” can also be cited if 

overuse / abuse of antibiotics persist in 

the LTC setting. The following Website was 

provided as a resource tool: http://nhguide. 

airprojects.org/tool3 

Julia A. Kiehibauch, Ph.D. presented 

Asymptomatic Bacteremia, comparing 

symptomatic vs. asymptomatic bacteremia 

treatment options. Essentially Asymptomatic 

Bacteremia is the presence of bacteria 

in a lab culture without any symptoms of 

active infection. Asymptomatic Bacteremia 

has many causes but the bottom line 

is treatment with antibiotics is usually 

inappropriate. Dr. Kiehibauch presented 

the “5 D’s of optimal antimicrobial therapy 

which are: 1) The correct Diagnosis, 2) The 

correct Drug (is the bacteria sensitive to the 

antibiotic?) 3) What is the correct Dose and 

4) Duration of therapy and (5) De-escalation; 

can the antibiotic be changed from IV to PO 

or discontinued completely? 

The Simon and Garfunkel songs “Bridge 

over Troubled Water” and “The 59th 

Street Bridge Song” were used to lead 

into “Bridging the Gap” presented by Lisa 

Schaffer, RN, CIC from Mountainview 

Hospital and Norman Wright, RN, BSN, MS 

from Kindred Hospital Sahara. The main 

thrust of their presentation was to break 

down barriers between our different health 

care providers and to promote the universal 

use of the Inter-Facility Infection Control 

Transfer Form when transferring patients 

between health care facilities. The goal is to 

have all Nevada Health Care entities use the 

form to communicate the MDRO history and 

antibiotic sensitivity patterns to the receiving 

health care provider. A computer generated 

version that can be modified to facility 

specific needs can be found at: 

Inter-Facility Infection Control Transfer 

Form (editable) http://dpbh.nv.gov/ 

uploadedFiles/dpbh.nv.gov/content/ 

Programs/HAI/dta/Training/InterFacility%20 

Infection%20Control%20Transfer%20 

Form(6).pdf 

For additional details on the topics, to 

communicate with the presenters, or to 

obtain information on how to implement 

the Infection Control Transfer Form please 

contact Kimisha Causey or Adrian Forero 

at the Nevada Department of Epidemiology 

(OPHIE) at: kcausey@health.nv.gov or 

aforero@health.nv.gov.


• B.S. in Nursing 

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• M.S. in Nursing 

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o Nurse Educator 

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o Family Nurse Practitioner 

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• DNP (Doctor of Nursing Practice) 

o BSN to DNP: 

• Nurse Practitioner Tracks 

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www.unr.edu/nursing


Falling Inward 

Tracey Long, PhD, RN, MSN 

Fall brings thoughts of ghosts, pumpkins, haunted houses and 

spirits. So as we fall forward in the calendar, let’s look inward to 

the spirit within us and explore spiritual health. With the rightful 

emphasis in evidence-based medicine and the western approach 

of germ theory and applicable research, spiritual health is often 

minimized or ignored. In many nursing theories however, the spiritual 

element of an individual is a key component to a holistic approach 

that recognizes the impact of the spirit on all areas of health. Western 

medicine generally focuses on the disease process and pharmaceutical 

treatments, however a holistic approach acknowledges the influence 

of a person’s inner spirit on health, illness and healing. If a patient 

is suffering from an infection, we correctly focus on the need for 

antibiotic treatment, however, it is also important to acknowledge the 

person’s emotional and spiritual condition in the recovery process. It 

is clear that a person’s spiritual health affects their physical health. A 

college religious Bishop was concerned about the spiritual health of his 

congregation as many of the students were coming to him complaining 

of depression and sleep disorders. Later he learned that their dietary 

and sleep habits were responsible for their depression as they ate no 

fruits or vegetables but fast foods and they sleep on average 4 hours 

each night. The students complained of brain fog and lethargy. Our 

spiritual health affects our physical health for good or bad. 

In most medical institutions, asking the patient about their religious 

affiliation is standard in the initial health assessment but often there is 

no further acknowledgement of their spiritual preferences. Simple and 

appropriate questions can demonstrate a nurse’s interest in delivering 

customized care, which includes spiritual preferences and support. A 

simple phrase to use could be “What can I do to support your spiritual 

health?” Some patients may act surprised by the new question or they 

may not have a preference, but it may be a welcome topic for others 

to discuss deeper issues that affect their overall health. An example 

may be offering the patient the opportunity to bring in their own 

religious music or simple relics or symbols that help heal their soul. 

One family brought in a CD player into a private ICU room of their 

loved one who had been in a coma for weeks. The religious music was 

allowed to gently play for hours that replaced the mechanical clicks 

and noise of an ICU. Functional MRI studies have shown that when 

people were allowed to look at religious symbols of their choosing, 

they rated their pain at lower levels than those who were not offered 

to look at any visual image (Wiech, et al, 2008). 

Many people associate religion and spirituality as the same, 

however they may be quite different. People without a formal religious 

affiliation may still be quite spiritual in their own use of meditation 

and inner peace practices. Studies show that patients with a religious 

belief or personal practice of prayer rate pain lower and actually 

heal faster than those who profess no religious or spiritual beliefs 

(Dedeli, 2013). Nurses frequently see patients who have numerous 

physical complaints without verified pathology but they do suffer 

from depression or “low spirits.” In contrast, nurses have witnessed 

a patient’s ability to heal and recover faster when they have a 

happy or faithful attitude. The strength or weakness of their spirit is 

manifest outwardly in their physical condition. Nurses who recognize, 

acknowledge and honor the spiritual element of a patient can help the 

patient heal from within. 

Now what about YOUR spiritual health? What are you doing to 

strengthen this important component within you? Is your spirit 

exhausted or energized by your nursing work? Often for nurses the 

answer is both. Nursing work can be exhausting with long hours and 

heavy patient assignments. It can be exhilarating with the occasional 

patient you connect with in deeper ways that energizes both you and 

your patient and recharges you for another shift. If your spirit is feeling 

consistently low however, that can become as scary and haunting as 

the ghostly images of Halloween. Identify your own spiritual self by 

answering these questions: 

• Where do you draw your energy and power from? 

• How do you communicate with your own divine center? 

• What is your personal mission statement and purpose in life? 

• How do you honor and commune with your Creator? 

When a nurse’s spirit is depressed, exhausted, lonely or angry, it is 

difficult to reach from within to help others you serve and work with. 

It’s as if having an empty emotional bank account and still trying to 

take out withdraws. A nurse’s spiritual health needs to be nurtured 

and nursed as much as your physical health. So this Fall season, fall 

within yourself and assess your own spiritual health. Design a nursing 

care plan to care for your own spirit so you can truly be your best 

self. Maybe your care plan will include a recommitment to regularly 

associate with your religious affiliation or daily reading in a spiritual 

text such as the Bible. Maybe it will include setting your smart phone 

to meditate for 10 minutes daily. Your patients need your spirit to be 

strong when theirs is often weak and sick. Make this Fall a season of 

healing and not haunting of your own spirit. 

References 

Dedeli, O. and Kaptan, G. (2013). Spirituality and Religion in Pain and Pain 

Management. Health Pscyhologial Res. Sep 24; 1(3): e29. Retrieved 

from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4768565/ 

Wiech K, Farias M, Kahane G, Shackel N, Tiede W, Tracey I, et al. (2008) 

“An fMRI study measuring analgesia enhanced by religion as a 

belief system.” Pain 139 (2):467–76. Retrieved from http://www. 

scienceonreligion.org/index.php/news-research/research-updates/117- 

the-impact-of-religious-beliefs-on-pain-perception 

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ANA News 

ANA Enterprise CEO Weston 

Announces Resignation 

SILVER SPRING, MD – After more than eight 

years of dedicated and visionary leadership, 

ANA Enterprise Chief Executive Officer Marla 

J. Weston, PhD, RN, FAAN, has announced her 

resignation, effective January 1, 2018. 

“We are indebted to Marla for her many 

years of stellar leadership, helping ANA gain the 

visibility and impact needed to be the premier 

organization for registered nurses, leading 

change and improving health for all,” said ANA 

President Pamela F. Cipriano, PhD, RN, NEA-BC, 

FAAN. “She has tirelessly led the Enterprise 

through bold transformative changes and guided 

us into new strategic directions.” 

Since becoming CEO in 2009, in partnership 

with the ANA Board of Directors, Dr. Weston 

had led the integration of three entities, the 

American Nurses Association, American Nurses 

Credentialing Center and American Nurses 

Foundation, into an enterprise; strengthened 

the membership recruitment and retention 

infrastructure resulting in high growth; enabled 

greater coordination and impact in ANA’s 

advocacy work; and sharpened ANA’s focus on 

the programs and services it offers to nurses. 

These changes have built a stronger ANA 

Enterprise through increased strategic alignment 

and operational efficiency. 

“It has been an honor and a pleasure to serve 

as the ANA Enterprise CEO,” said Dr. Weston. 

New Medicare Cards Offer Greater Protection 

to More Than 57.7 Million Americans 

New cards will no longer contain Social Security 

numbers, to combat fraud and illegal use 

The Centers for Medicare & Medicaid 

Services (CMS) is readying a fraud 

prevention initiative that removes Social 

Security numbers from Medicare cards to 

help combat identity theft, and safeguard 

taxpayer dollars. The new cards will use a 

unique, randomly-assigned number called 

a Medicare Beneficiary Identifier (MBI), to 

replace the Social Security-based Health 

Insurance Claim Number (HICN) currently 

used on the Medicare card. CMS will begin 

mailing new cards in April 2018 and will meet 

the congressional deadline for replacing all 

Medicare cards by April 2019. Today, CMS 

kicks-off a multi-faceted outreach campaign 

to help providers get ready for the new MBI. 

“We’re taking this step to protect our 

seniors from fraudulent use of Social Security 

numbers which can lead to identity theft 

and illegal use of Medicare benefits,” said 

CMS Administrator Seema Verma. “We 

want to be sure that Medicare beneficiaries 

and healthcare providers know about these 

changes well in advance and have the 

information they need to make a seamless 

transition.” 

Providers and beneficiaries will both be able 

to use secure look up tools that will support 

quick access to MBIs when they need them. 

There will also be a 21-month transition period 

where providers will be able to use either the 

MBI or the HICN further easing the transition 

CMS testified on Tuesday, May 23rd before 

the U.S. House Committee on Ways & Means 

Subcommittee on Social Security and U.S. 

House Committee on Oversight & Government 

Reform Subcommittee on Information 

Technology, addressing CMS’s comprehensive 

plan for the removal of Social Security 

numbers and transition to MBIs. 

“I am proud of how far the Enterprise has 

progressed and believe the time is right for me 

to step down. I remain deeply committed to and 

passionate about my profession and ANA. ” 

Dr. Weston will continue in her full-time role 

until the end of the year, and is committed to 

supporting a successful transition for the new 

CEO. The ANA Board of Directors will engage in 

a search process to select the next CEO. 

# # # 

The ANA Enterprise is the organizing 

platform of the American Nurses Association 

(ANA), the American Nurses Credentialing 

Center (ANCC), and the American Nurses 

Foundation. The ANA Enterprise leverages the 

combined strength of each to drive excellence 

in practice and ensure nurses’ voice and vision 

are recognized by policy leaders, industry 

influencers and employers. From professional 

development and advocacy, credentialing and 

grants, and products and services through 

its Nursing Knowledge Center division, the 

ANA Enterprise is the leading resource for 

nurses to arm themselves with the tools, 

information, and network they need to excel in 

their individual practices. In helping individual 

nurses succeed—across all practices and 

specialties, and at each stage of their careers— 

the ANA Enterprise is lighting the way for the 

entire profession to succeed. 

Personal identity theft affects a large and 

growing number of seniors. People age 65 or 

older are increasingly the victims of this type 

of crime. Incidents among seniors increased 

to 2.6 million from 2.1 million between 2012 

and 2014, according to the most current 

statistics from the Department of Justice. 

Identity theft can take not only an emotional 

toll on those who experience it, but also a 

financial one: two-thirds of all identity theft 

victims reported a direct financial loss. It can 

also disrupt lives, damage credit ratings and 

result in inaccuracies in medical records and 

costly 

false claims. 

Work on this important initiative began 

many years ago, and was accelerated 

following passage of the Medicare Access and 

CHIP Reauthorization Act of 2015 (MACRA). 

CMS will assign all Medicare beneficiaries a 

new, unique MBI number which will contain 

a combination of numbers and uppercase 

letters. Beneficiaries will be instructed to 

safely and securely destroy their current 

Medicare cards and keep the new MBI 

confidential. Issuance of the new MBI will not 

change the benefits a Medicare beneficiary 

receives. 

CMS is committed to a successful transition 

to the MBI for people with Medicare and for 

the health care provider community. CMS has 

a website dedicated to the Social Security 

Removal Initiative (SSNRI) where providers 

can find the latest information and sign-up 

for newsletters. CMS is also planning regular 

calls as a way to share updates and answer 

provider questions before and after new cards 

are mailed beginning in April 2018. 

For more information, please visit: https:// 

www.cms.gov/medicare/ssnri/index.html 

American Nurses 

Association Calls 

for Action in Wake 

of Police Abuse of 

Registered Nurse 

SILVER SPRING, MD – The American 

Nurses Association (ANA) is outraged that 

a registered nurse was handcuffed and 

arrested by a police officer for following her 

hospital’s policy and the law, and is calling 

for the Salt Lake City Police Department to 

conduct a full investigation, make amends to 

the nurse, and take action to prevent future 

abuses. 

The incident occurred July 26 at University 

Hospital in Salt Lake City, Utah and video 

footage of the incident was recently released. 

Registered nurse Alex Wubbels was arrested 

after refusing to draw blood from an 

unconscious patient who had been injured in a 

collision and was a patient on the burn unit. 

According to the video, Nurse Wubbels 

shared details about the hospital’s policy 

with the police officers and consulted her 

supervisors in responding to the detective’s 

request. Wubbels cited the hospital’s policy, 

stating that blood could not be taken from 

an unconscious patient unless the patient 

is under arrest, a warrant had been issued 

for the blood draw, or the patient consents. 

The police officers stated that they had 

implied consent to get the blood sample 

and they believed that the hospital’s policy 

contravened their duty to enforce the 

law. However, “implied consent” has not 

been Utah law for more than a decade. 

Additionally, the U.S. Supreme Court ruled in 

2016 that warrantless blood tests go against 

privacy interests and public safety and 

therefore are not allowed. 

“It is outrageous and unacceptable that 

a nurse should be treated in this way for 

following her professional duty to advocate 

on behalf of the patient as well as following 

the policies of her employer and the law,” 

said ANA President Pam Cipriano, PhD, RN, 

NEA-BC, FAAN. 

According to the Code of Ethics for Nurses 

with Interpretive Statements, “the nurse 

promotes, advocates for, and protects the 

rights, health, and safety of the patient.” 

Unfortunately, nurses often are victims of 

violence on the job. In 2015, ANA adopted 

a policy of “zero tolerance” for workplace 

violence and called on nurses and their 

employers to work together to prevent and 

reduce the incidence of workplace violence. 

“Nurses and police officers work 

collaboratively in many communities,” 

said Cipriano. “What occurred is simply 

outrageous and unacceptable. Nurse Wubbels 

did everything right. It is imperative that 

law enforcement and nursing professionals 

respect each other and resolve conflicts 

through dialogue and due process.” 

OR Training for RN’s is Here!


Increasing Breast Cancer Awareness: What You Should Know 

Denise S. Rowe, DNP, MSN, APRN, FNP, BC 

Breast cancer is the most common cancer in American 

women other than skin cancer. (ACS, 2017) It is the second 

leading cause of cancer deaths per year in women, second 

only to lung cancer. (CDC, 2017) The risk that a woman will 

die from breast cancer is about 2.7% or 1 in 37. (ACS. 2017). 

In the United States (US) there are about 220,000 annual cases 

of breast cancer diagnosed in women compared to 2,000 cases in men 

(CDC, 2017). Approximately 40,000 women and 400 men in the US 

die every year from breast cancer. The average age of breast cancer 

diagnosis in the US is 61 for women and between 60 and 70 years for 

men. In recent years, incidence rates of breast cancer have been the 

same in white and African American women however, breast cancer 

is more common in white and African American women compared 

to women of other races/ethnicities (ACS, 2017). In 2014, the most 

recent year for which numbers have been reported, white women 

had the highest incidence rate for breast cancer, followed by black, 

Hispanic, Asian/Pacific Islander, and American Indian/Alaska Native 

women (CDC, 2017). There are more than 3.1 million breast cancer 

survivors in the United States (ACS, 2017). 

Risk Factors 

The risks for breast cancer include female gender (100 times more 

common than men), getting older (particularly an age above 55), a 

family history of breast cancer (parent, sibling or child), history of never 

giving birth, first menstrual period before age 12, starting menopause 

after age 55, overweight or obesity, excessive alcohol consumption 

(more than 2 alcoholic drinks per day), lack of physical activity, taking 

hormone therapy after menopause, radiation therapy to the chest, 

and genetic defects in certain genes (BRCA1 and BRCA2) (CDC, 2017) 

The most common signs of breast cancers include lump in breast or 

underarm, pain in breast, dimpling, thickening, or swelling of any part 

of the breast, retraction of nipple, pain and redness in and around the 

nipple, nipple discharge other than breast milk (including blood). 

Genetic Testing 

If there is a personal or family health history of breast cancer 

or an indication that breast cancer-related genetic mutations (e.g. 

BRCA1, BRCA2) is a factor, genetic counseling may be considered. 

With mutations of the BRCA1 and BRCA2 genes the risk for breast 

cancer is quite high. For BRCA1 the average breast cancer risk 

ranges between 55-65% but can be as high as 80% over a lifetime. 

By comparison, BRCA2 mutations have a breast cancer risk of 

about 45%. (ACS, 2017) 

Screening 

A clinical breast exam by a health care provider is recommended 

to evaluate any reported physical breast symptoms. There are 

different organizational guidelines for breast cancer screening. 

For women between age 45 to 54 who have an average breast 

cancer risk, the American Cancer Society recommends an annual 

screening mammogram (ACS, 2017). At age 55 and above, 

screening mammograms can be performed every 2 years for as 

long as life expectancy is anticipated to be greater than 10 years. 

The American College of Obstetricians and Gynecologists (ACOG), 

recommends mammograms every 1-2 years between age 40- 

49 and every year after age 50. The U.S. Preventive Services 

Task Force proposes screening every 2 years starting at age 50 

(Medscape, 2016). For women at high risk (20-25% and above) an 

annual mammogram and breast magnetic resonance imaging (MRI) 

is recommended. (ACS, 2017) 

The Nevada Health Centers provide statewide mammography 

through a mammovan service to women in underserved areas and 

women who are uninsured or of low income (Nevada Health Partners, 

2017). The Nevada Division of Public and Behavioral Health’s Women’s 

Health Connection Program also provides mammograms to lowincome, 

high risk, uninsured or underinsured women (DPBH, 2017). 

References 

1. American Cancer Society (ACS) (2017). Breast Cancer Statistics. 

Retrieved from https://www.cdc.gov/cancer/breast/index.htm 

2. Centers for Disease Control and Prevention (2017). Breast Cancer 

Statistics. Retrieved from https://www.cancer.org/cancer/breastcancer.html 

3. Centers for Disease Control and Prevention (2017). Breast Cancer 

Fact Sheet. Retrieved from https://www.cdc.gov/cancer/breast/pdf/ 

breastcancerfactsheet.pdf 

4. Medscape (2016). Breast Cancer Screening. Retrieved from http:// 

emedicine.medscape.com/article/1945498-overview 

5. Nevada Health Partners (2017). Health Services. Retrieved from 

https://www.nevadahealthcenters.org/services/mammovan/. 

6. Nevada Division of Public and Behavioral Health (2017). Community 

Resources. Retrieved from http://dpbh.nv.gov/Community/ 

Resources-New/ 

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We offer: 

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From Dice to Rice 

By Tracey Long PhD, MSN, RN 

Leaving the entertainment capital of the world in Las Vegas to 

eating rice and beans three meals a day for two weeks, nursing 

students from Chamberlain University, Nevada State College and 

the College of Southern Nevada volunteered in the Caribbean in 

free medical clinics. Students visited homes in 3 communities and 

helped the ministry of health in the Dominican Republic and Haiti by 

completing surveys in homes for running water, electricity and toilet 

services. Using translators and local physicians, students worked 

to triage patients and collaborate with the physicians in the general 

medicine clinics for diagnosis and treatment. They each had the 

opportunity to work in the simple pharmacy, and teach patients about 

basic health education and medication management. Nursing students 

who served with International Service Learning and Dr. Tracey Long 

included Jamerson Holloway, Katie Beattie, Tiffany Ramirez and 

Dionne Joseph from Chamberlain University, Taylor Libbey and Victoria 

Maracle from CSN and Gladys Nicolas from NSC. “During my time 

spent in the DR and Haiti I truly learned the meaning of service and 

the value that comes from living and serving. The people and children 

taught me something I could never learn or articulate from a textbook. 

My heart has never been so full after an experience and I’m grateful I 

was able to experience this with such amazing people” reflected Taylor. 

Students and saw patients with various tropical diseases such as a 

community outbreak of chicken pox, fungal infections, secondary skin 

infections and parasitic gastrointestinal disorders. They completed 

hundreds of health assessments and mastered the SBAR presentation 

of clients to the physicians. They were able to compare and contrast 

the medical systems and challenges of these two Caribbean nations 

on one island. Several students were able to administer their first 

IM injections and how to compare common US medications to the 

generics available in these countries. “I’ll never forget my first IM 

injections for a man, his wife and his girlfriend who were all treated for 

an STI all at the same appointment time” mused Jamerson. Not only 

did they learn about medicine, but they learned how to dance the Latin 

merengue, speak survival Spanish, collaborate with people of different 

cultures and how warm, clear and gorgeous the Caribbean ocean is. 

“The people are beautiful and so grateful. So many of the patients 

dressed in their “Sunday best” when they came to the clinic and 

offered us much out of their lack while we gave so little in comparison 

out of our abundance. Serving with fellow students was priceless. I 

strongly encourage everyone to use their knowledge and gifts to serve 

here and abroad” stated nursing student Victoria. This trip to Haiti and 

the Dominican Republic was truly a life altering experience. I am more 

grateful for the many blessings I have. 

Jamerson smiled widely as he said, “I’ve learned to smile more 

because the beautiful Dominican and Haitian people were always 

smiling and if they can smile with so little in material belongings, then 

there is no reason for me not to smile since I’m so blessed.” 

Students earned money to pay their own way to volunteer and 

came home with much more than souvenirs. “The experiences you 

get from these international service trips are unforgettable. You not 

only get to help out those who really need your services but you 

get to submerge yourself in their culture as well. This is definitely 

something I recommend everyone experience” said Tiffany. Nursing 

students and nurses who are interested in serving in a medical trip 

summer 2018 in India or China please contact Dr. Tracey Long at 

longforhome@gmail.com. 

Located just 30 minutes from Las Vegas, we have been providing quality care to our community since 1931! 

Boulder City Hospital is about providing Quality Care Close to Home! 

Growth Potential 

Competitive Wages 

Predictable Schedules 

Comprehensive Benefits 

including 403b and generous PTO 

Currently seeking experienced RN’s in: 

Long Term Care (RN’s, Charge RN and MDS) 

Medical Surgical/ Tele • Surgical Service 

ER • Nursing Leadership 

Contact us at: 702-293-4111 ext 533 or e-mail HR@BoulderCityHospital.org • www.bchcares.org


UNLV School of Nursing and UMC Form a New Academic Practice Partnership 

Submitted by Mary Bondmass on behalf of the UNLV/UMC Academic Practice Partnership 

The University of Nevada Las Vegas 

(ULNV) School of Nursing (SON) and the 

Department of Nursing at University Medical 

Center begin a new Academic Practice 

Partnership this month in opening the first 

of UMC Dedicated Education Units (DEU). A 

DEU is a specific unit wherein pairs of nursing 

students work directly with a specially 

trained staff nurse (known as a Clinical 

Dedicated Instructor or CDI). The DEU 

creates an optimum learning environment for 

students. Each CDI mentors two students. 

School of Nursing faculty further develop 

the teaching skills of each CDI to ensure 

students receive the appropriate level of 

instruction and training. 

The DEU replaces the traditional clinical 

teaching model of eight students to one 

clinical faculty from the SON. The SON 

Faculty are still be on site on clinical days 

and ‘round’ frequently on the student, but 

now will serve in more of a consultative 

role versus one of direct patient care. The 

clinical faculty consultant or CFC (i.e., UNLV 

faculty) are available as a resource and work 

collaboratively with the CDI to facilitate the 

students’ learning. 

UMC’s medical-surgical unit (1500) is 

the site of the first DEU. The excitement 

was palpable at the first-ever white coat 

ceremony held last month to honor the new 

CDIs who received their white lab jackets 

signifying that they are clinical experts and 

now specially trained in clinical education 

pedagogical methods to teach nursing 

students. 

Above are the new CDI with the unit manager, 

charge nurse and clinical supervisor. 

The banner outside UMC’s 1500 indicates that 

this unit is dedicated to UNLV nursing students


Nevada Nurses Foundation 

The Nevada Nurses Foundation has been awarding scholarships 

since 2015 after receiving a non-profit tax-exempt, 501(c)(3) 

status in 2014. Because of the generous charitable gifts received 

throughout the years, over 40 nurses/student nurses received a 

scholarship totaling over $50,000.00. The Foundation scholarship 

recipients are awarded to nursing scholars throughout Nevada based 

on their application score. Strict adherence to applicant’s privacy 

reduces the risk of discrimination based on residence, educational 

facility, gender, age, race, religion, or any other protected identifiers. 

Of the total scholarship recipients, 40% percent live in northern 

Nevada, 37.5% live in southern Nevada, 20% live in Rural Nevada, 

and 2.5% resides in both the north and south. Names of the 

scholarship recipients are posted on the nvnursesfoundation.org 

website. 

Although we have not reached our goal to have 50 annual 

“Named” scholarship sponsors, we thank all of our wonderful 

“Named” scholarship sponsors. Jessie Valentine scholarship by 

Carson Tahoe Health, Dr. Ian Choe and Teresa Praus, APRN, Dr. 

Jami-Sue Coleman, Katherine “Kat” Cylke, Arthur L. Davis by Mark 

Miller, Martha Drohobyzer, Dr. Elizabeth Fildes, Hurst Review, 

Christine Watson scholarship by Dr. Susan and Paul Michael, 

Tiffany Urresti Memorial Flight Nurse Scholarship by Life Guard 

International Flying ICU & Donna Miller, Nevada Advanced Practice 

Nurses Association, Nevada Alliance for Nursing Excellence, 

Nevada Nurses Association, District 1, Rosemary Witt Scholarships 

by Nevada Nurses Association, District 3, Mary Lucell Johnson 

Scholarship by Dr. Denise Ogletree McGuinn, Emma Marrujo 

Redmon by Dr. Sandy Olguin, Betty Razor ‘Wound Ostomy Care 

Nurse’ Scholarship, Rural & Frontier Nurses Committee & Friends, 

and Debra Scott, Dr. Eugene Somphone. 

The Betty Razor ‘Wound 

Ostomy Care Nurse’ 

scholarships of $2,700 

was awarded to Amy 

Woods, BSN, RN. Betty 

and Amy met at a WOCN 

dinner after Amy received 

her certification. Amy, a 

native Nevadan 

graduated from TMCC 

with her ADN then 

received her BSN from 

UNR. She aspires to 

improve wound care treatment outcomes within the home 

environment by educating patients and families, collaborating 

with physicians, and understanding best treatment options for 

each patient. 

Great news!! Next spring 2018, the Foundation will begin 

awarding grants to leaders in nursing who are developing a 

program, project, or research that supports the NNF mission. The 

NNF mission is to increase access to quality health care for Nevada 

citizens by promoting the professional development of nursing 

through recognition, scholarships, and grants. Thank you Dr. Glenn 

Hagerstrom, Dr. Heidi Johnston, Vicky Lang Catlin, Rev. Dr. Denise 

Ogletree McGuinn, Dr. Sandy Olguin, Lyle Pritchett and Dr. Julie 

Wagner for developing the grant process. 

On October 7, 2017, many festive hats and outfits will be adorned 

by the 160 guests at the 3rd annual Nevada Nurses Foundation’s 

“Mad Hatter” Big Hat High Tea at the Governor’s Mansion. 

The Nevada Nurses Association and Nevada Organization of 

Nurse Leaders Convention will be held at the Grand Sierra Resort 

on November 30th and December 1st. Thanks to NNA and NONL, 

the Nevada Nurses Foundation will be sponsoring Nurses Have 

Talent, a very fun and entertaining fundraising event on Thursday, 

November 30th that is open to the public. All proceeds promote the 

Foundation’s mission by raising money for scholarships. Tickets are 

$20 pre-event and $30 at the door. 

At the Future of Nursing in Nevada (FONN) Awards Gala, over 

500 Nevada nurses and student nurses have been recognized. With 

the anticipation of expanded growth over the years to come, the 

Foundation is appealing to all professional nursing organizations, 

health care institutions, and interested community members to be 

a FONN partner and volunteer. 

Thank you and have great days, 

Sandy 

TO MAKE A DIFFERENCE, BE THE DIFFERENCE. By Julian Hall 

EIN 47-1388572 

JOIN US IN SERVING 

« THE BEST! « 

Nurse Practitioners 

Advance Practice RNs 

RNs, LPNs, NAs 

Looking for a career where you can help our country’s Veterans? 

We have immediate openings for Nurse Practitioners as well as 

Advance Practice Registered Nurses (APRN), Registered 

Nurses, LPNs & NAs in multiple areas at our facility. 

VA nurses have the opportunity to participate in research initiatives 

focused on enhancing health and preventing disease among our Nation’s 

Heroes; you will also be able to further your career through our various 

nursing leadership and clinical development programs. 

We encourage you to consider employment at the VA Sierra Nevada 

Health Care System in Reno, NV. Join a team that values a healthy 

home/work life balance and be rewarded by the role you’ll play 

in keeping the promise to those who served. 

Visit USAJobs.gov to apply. Nurse Practitioners, please 

contact Susan Oliver at susan.oliver@va.gov, (775) 829-5644. 

APRNs, RNs, LPNs & NAs please contact Danielle Del Prete 

at Danielle.delprete@va.gov, (775) 829-5637. 

Apply Today: USAJobs.gov 

Follow VA 

Careers


NNA State Board to Partner in ANA 

Student Loan Refinancing Benefit 

The Nevada Nurses Association has decided to join ANA in 

partnering with CommonBond, a leading student lender, to help our 

members save money through student loan refinancing. Refinancing 

your federal or private student loans to a lower interest rate can 

save you thousands. CommonBond saves their members $24,046 on 

average4, in addition to offering award-winning service and a simple 

application process. Plus, ANA members get $300 cash back from 

CommonBond when they refinance! 

Visit CommonBond to learn more. 

The Nevada Safe Staffing Task Force 

The Nevada Safe Staffing Task Force grew out of the Safe Staffing 

meetings held in February this year. Based on the summary results 

from those meetings, several priorities were identified and the group, 

with representation from NNA, NONL, NHA, and ANA, decided to begin 

meeting to work on some of the most pressing issues. The current 

goal is to develop safe staffing toolkits for each of the following: 

Bedside nurses, nurse leaders, new graduate nurses, and clarification 

of issues surrounding the use of the ADO form. Additionally, groups are 

working on data collection for the Task Force and a module for Senior 

Nursing Students. 

If you are interested in becoming involved with the Task Force, please 

contact Margaret Curley MCurley@nvnurses.org or call 775-747-2333. 

The Department of Corrections offers 

many medical job opportunities: 

Medical Positions 

Mid-Level Medical Practitioners, Senior Physicians, Dentists, 

Dental Assistants, Licensed Practical Nurses, Correctional 

Nurses, Psychiatric Nurses, Certified Nursing Assistants, Lab 

Technicians, Pharmacists, Pharmacy Technicians, Substance 

Abuse Counselors, Psychologists, Mental Health Counselors 

SEE OUR OPENINGS AT: nvapps.state.nv.us 

Tuition Reimbursement available for some locations 

Email: twickham@doc.nv.gov | Phone: 775-887-3220


Bleeding 

Control Training 

On July 29, 2017, a group of nurses, 

firefighters, nursing students, and 

others learned how to save lives in an 

emergency by stopping the bleeding 

in a patient with a traumatic injury. 

The training, sponsored by NNA, 

was held at Great Basin College and 

presented by a team of trauma/critical 

care nurses and firefighters. To learn 

more about this national initiative, 

visit bleedingcontrol.org. 

Membership 

Figure 1 Trauma nurse Rebecca Gilbert 

Figure 2 Firefighter David Morris demonstrates 

positioning patient in recovery position 

Figure 3 Maria Miralles, Rebecca Gilbert, Amy 

Pant, David Morris 

Seeking Adventurous, Compassionate Nurses 

That research paper isn’t going to write itself. 

Visit www.nursingALD.com 

to gain access to 1200+ issues of official state nurses 

publications, all to make your research easier! 

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Nevada RNFormation – November 2017

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