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RN Idaho - February 2018

Page 8 •

Page 8 • RN Idaho February, March, April 2018 Idaho Board of Nursing Update Sandra Evans, Executive Director At the reading of this update from your Board of Nursing, 2017 will have come to an end and a new year filled with energy and anticipation will have begun. Although the Board of Nursing operates on a fiscal year that begins each July 1 and ends on June 30, the calendar New Year is still regarded as a time for closure with the opportunity to reflect and begin anew. The Board begins 2018 knowing Idaho continues to be positioned nationally as a recognized leader in nursing regulation, a status the Board has worked to achieve and sustain over the past many years. Idaho’s position is evidenced by: • Alternatives to discipline for nurses whose practice is/may be impaired due to substance use and/or mental health disorders (the Program for Recovering Nurses - PRN) and nurses with identified practice deficiencies that may be remedied through education or remediation (the Practice Remediation Program – PRP); • Integration of concepts of “just culture” into all licensure and discipline decisions; • Paperless licensure processes that extend to all LPN, RN and APRN licensure applications including initial licensure by examination and endorsement, license renewal and reinstatement, temporary and conditional licensure and emeritus-status licensure; • Full implementation of national ‘Uniform Licensure Requirements’ for LPNs and RNs, including fingerprint-based criminal background checks; success on the NCLEX or its predecessor, the State Board Test Pool Examination; graduation from a Board of Nursing recognized nursing education program or its equivalent; and demonstrated nursing knowledge, English proficiency and unencumbered authority to practice in their country of origin for nurses educated outside the United States and its territories; • Full alignment with elements of the national Consensus Model for the Regulation of Advanced Practice Registered Nurses (APRN), including: • Regulation of the 4 APRN roles (certified nurse midwife, certified nurse practitioner, certified registered nurse anesthetist and clinical nurse specialist) solely under the statutory authority of the Board of Nursing; • Completion of APRN role and population-specific education by a nationally accredited educational program, current national APRN certification, and RN authority to practice as essential criteria for APRN licensure; • Defined independent practice and prescribing authority without required physician supervision for all licensed APRNs; • Uniform title designations of “APRN” followed by the appropriate APRN role, e.g. “APRN, CNM ”, “APRN, CNP ”, “APRN, CNS ”, “APRN, CRNA”; • Redefined “practice of nursing” that addresses where, what, and by whom; clarifies that practice occurs at the location of the recipient of nursing care/services; and includes “other interfaces” in which licensed nurses may engage with non-licensed individuals in both care and non-care settings; • Requirements for demonstrated continued professional development as a condition of LPN and RN license renewal beginning with the 2018 LPN renewal; • Full compliance with reporting requirements to the National Practitioner Data Bank (NPDB) and FBI fingerprint report management requirements as evidenced by recent audits by the NPDB, FBI and Idaho State Police; • Enactment on July 1, 2016 and implementation on January 19, 2018 of the ‘enhanced’ Nurse Licensure Compact (eNLC). The eNLC replaces the previous NLC implemented in Idaho in 2001. Nurses holding an Idaho multistate license on January 19 were automatically grandfathered with a multistate license into the new Compact on that date. The NLC/eNLC is recognized nationally and internationally as an effective nurse licensure model that enhances the geographic mobility of nurses and promotes patient access to care, both physically and electronically, including care delivered via telehealth. At the writing of this “Update,” eNLC members included: Arizona, Arkansas, Delaware, Florida, Georgia, Idaho, Iowa, Kentucky, Maine, Maryland, Mississippi, Missouri, Montana, Nebraska, New Hampshire, North Carolina, North Dakota, Oklahoma, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, West Virginia and Wyoming. Other states considering adoption in 2018 include: Colorado, Massachusetts, Nevada, New Jersey, New Mexico and Wisconsin to date. The Idaho Board’s Vision to “regulate nursing with collaboration, innovation and strategic leadership to ensure the nursing workforce meets the changing needs of Idahoans” continues to guide the Board in its regulatory work. The nine appointed members of the Idaho Board of Nursing meet quarterly for the conduct of regular business, including responsibilities related to licensure, practice, education, discipline, alternatives to discipline, communication, governance and organization. Current Board members include Vicki Allen, RN, Pocatello, Chair; Carrie Nutsch, LPN, Jerome, Vice Chair; Jennifer Hines-Josephson, RN, Rathdrum; Whitney Hunter, Consumer, Boise; Jan Moseley, RN, Coeur d’Alene; Rebecca Reese, LPN, Post Falls; Clay Sanders, APRN, CRNA, Boise; Merrilee Stevenson, RN, Wendell; and Reneé Watson, RN, Boise. At their meeting on October 12-13, 2017, Board members: • Reviewed the status of Idaho facilities that employ Board-approved nurse apprentices (currently enrolled nursing students employed for remuneration in a non-licensed capacity); • Engaged in dialogue with two nurses each presenting an issue of concern during the ‘Open Forum’, a scheduled highlight of each meeting. Issues included: 1) Current role of the nurse apprentice and consideration of possible future expansion 2) State requirement for disclosure of one’s US Social Security Number on an application for Idaho licensure; • Considered updates on various projects and initiatives, including results of the recent audit of Idaho’s compliance with reporting requirements to the NPDB; progress toward successful launch of the Board’s new in-house data management software program that includes the Idaho Nurse Portal; recent meetings/outcomes of the Board’s Program for Recovering Nurses (PRN) and APRN Advisory Committees; results of the recent audit of the Board’s fiscal management processes by the state Legislative Services Office; progress to date on pending administrative rules and one legislative bill to be introduced to the 2018 Idaho Legislature for adoption; and progress to date on proposed rules necessary for implementation of the new Nurse Licensure Compact. • Took action to: • Appoint Jessica Jameson, MD, Post Falls, to a 3-year term on the APRN Advisory Committee; Dr. Jameson is a pain management specialist and founding partner of Axis Spine Center, Post Falls, ID; • Appoint Alissa Miller, RN, to a second 3-year term on the PRN Advisory Committee; Ms. Miller is employed at Kootenai Behavioral Health, Coeur d’Alene, ID; • Accept APRN certifying organizations approved by the National Council of State Boards of Nursing as aligned with the APRN Consensus Model and population focus areas as recommended by the APRN Advisory Committee; • Revoke the license of an RN for failure to comply with terms and conditions of participation in the PRN; • Deny an application for RN licensure by examination citing false representation of facts on the application for licensure. EXECUTIVE ORDER NO. 2017-06 On May 19, 2017, Lieutenant Governor Brad Little, in his capacity as acting governor, signed Executive Order No. 2017-06, requiring a review of Idaho’s occupational licensing requirements. The Lieutenant Governor wants to hear from those affected by licensing requirements. Go to https://www.ibsp.idaho.gov/EO%202017-06.pdf to read the order. Comments can be emailed to freedomact@lgo.idaho.gov or posted at lgo.idaho.gov/freedomact/. In addition, the Board encourages the public, including licensed nurses, to complete a brief, anonymous on-line survey accessible on the Board’s website at https://ibn.idaho. gov/IBNPortal/ before May 1, 2018 to assist the Board in further complying with the order. Results of the survey will be reported in the aggregate as part of the Board’s report to Lieutenant Governor Little this coming spring. As always, the Board invites the public to attend scheduled Board meetings and participate in the ‘Open Forum’ held on the second day of each meeting. The ‘Open Forum’ provides the opportunity to dialogue with the Board on issues of interest that are not necessarily included on the published agenda. The Board will not take action on issues introduced during the Forum, but may choose to address them at a later scheduled Board meeting. The next meetings of the Board are tentatively scheduled for January 18-19, April 19-20, July 26-27, and November 1-2, 2018 in Boise at a location to be determined. For further information, visit the Board’s website or contact the Board office at 208.577.2476. Reference Idaho Board of Nursing (2017). FY204 Strategic Plan: Board vision statement. Retrieved from https://ibn.idaho.gov/IBNPortal/IBN/publications/Strategic%20Plan%20-%20FY%202014- 2017.pdf

February, March, April 2018 RN Idaho • Page 9 Self Care Corner... As we reflected on the powerful ANA Idaho annual conference entitled Inside Out: Caring for Yourself While Caring for Others, the RN Idaho editorial board decided to do something specific toward empowering this notion of “self-care while giving care.” We present to you a new segment devoted to the task of self-care. In the coming year, we hope you enjoy this series designed poignantly toward enriching the every-day lives of care givers by sharing of practical knowledge, providing simple self-care tools, and offering encouragement to you, the Idaho nurse. We hope you find it uplifting and worthwhile because you are important! Your health and your life matter. A Year of Self-Care Carrie Anstrand, MA, BSN, RN, LCCE, IBCLC carriealuv@icloud.com Thank you for walking through the past year on a journey of improved self-care with me in our Self-Care Corner column. Now that we are enjoying 2018, I want to leave you with a poignant set of graphics I came across from author and licensed clinical psychologist, Dr. Claire Nicogossian. She gave me permission to share these with you because she knows nurses are the backbone of healthcare and need outstanding self-care practices. You have a year of tools from RN Idaho to do so! I encourage you to engage in devoted time toward your personal growth, by nurturing and developing your self-care muscles. After all, YOU are the strength of our Nation, YOU are a Nurse. For more information about Dr. Claire and her work helping others foster self-care, she is available on line at www.momswellbeing.com. Remember past issues of RN Idaho are available on line on the ANA Idaho website at idahonurses.org. Resource Nicogossian, Claire. Self-Care graphics. 2014. Retrieved from http://momswellbeing.com/part-2-how-to-increase-self-carein-your-life/.jpg. Knowledge Deficit within the Nursing Community about LGBTQ Issues Byron Fjeld, BSN, RN, Katelyn King, BSN, RN, Alexandra Mitchell, BSN, RN, CD, Meghan Sparks, BSN, RN mesparks@lcmail.lcsc.edu Acceptance has grown within the last few decades leading to an ever growing and evolving lesbian, gay, bisexual, transgender and queer (LGBTQ) community. With this expanding group comes new room for knowledge in healthcare. Healthy People 2020 and the Institute of Medicine have marked healthcare for the LGBTQ community as a priority in the United States. With decreased access to health insurance and preventative care but increased prevalence of mental health issues and sexually transmitted disease, there is obvious change needed in healthcare. In fact, according to Orgel (2017), LGBTQ youth are two to three more times likely to commit suicide with a shocking 41% of transgender individuals having attempted suicide. Substance abuse is at a rate of 20-30% in the LGBTQ community compared to 9% in the general population (Orgel, p. 2, 2017). Even with these alarming statistics nursing schools are not required to include LGBTQ issues for accreditation within their curriculums. In a survey of nursing faculty from baccalaureate nursing programs, it was found that 69% of nurse educators felt that LGBTQ health issues were important; however 63% also indicated they rarely covered health topics related to LGBTQ in the classroom (Lim, Johnson, & Eliason, p. 151, 2015). There are new and recent changes to the way in which people are identified. It is important to analyze where nurses’ current knowledge lies and what can be learned. Unfortunately, because of stigma, only one third of providers even ask about sexual orientation, and many people will not identify their true orientation. Due to healthcare professionals’ hesitancy to interact with LGBTQ individuals, this leads to poor assessments/treatments and lack of prevention for future health issues. Big pushes for change are happening to promote inclusiveness throughout society. Things such as nongender specific bathrooms, proper use of pronouns and same sex marriage are just a few examples of this. With these changes, new education needs to be implemented not only for people of the LGBTQ communities but also for the general public. Sexual orientation has been hidden in the past, and though it is becoming more of an openly accepted culture, there is a gap in education that needs to be addressed within the medical profession. Education should include things like appropriate proper pronoun use, what to look for with mental health issues within this community, the use of gender inclusive forms, awareness of support services, and ways to properly take care of a person who identifies as LGBTQ. Nurses have the duty to make everyone feel safe and comfortable no matter their religion, race, ethnicity, or sexual orientation. Nurses must be aware of the issues faced by members of the LGBTQ community and work to provide a safe and welcoming environment for this population. References: Lee, R. (2000). Best practice. Health care problems of lesbian, gay, bisexual, and transgender patients. WJM: Western Journal of Medicine, 172(6), 403-408. Lim, F., Johnson, M., & Eliason, M. (2015). A national survey of faculty knowledge, experience, and readiness for teaching lesbian, gay, bisexual, and transgender health in baccalaureate nursing programs. Nursing Education Perspectives (National League For Nursing), 36(3), 144-152. doi:10.5480/14-1355 Lim, F. A., & Bernstein, I. (2012). Promoting awareness of LGBT issues in aging in a baccalaureate nursing program. Nursing Education Perspectives (National League For Nursing), 33(3), 170-175. doi:10.5480/1536-5026-33.3.170 Orgel, H. (2017). Improving LGBT cultural competence in nursing students: An integrative review. ABNF Journal, 28(1), 14-18. Cascade Medical Center has an opening for a Physician Assistant or Nurse Practitioner to join our team in beautiful Cascade, Idaho. The mid-level practitioner we are looking for will have experience taking care of family practice patients, emergency, swing bed and inpatients. The position requires working a 30 hour clinic schedule during the week and shared Emergency Room Coverage with 3 other providers. Competitive pay with bonus potential, excellent benefits and a relaxed friendly working environment. For more information or to apply for the position please contact: Charles W. Johnston, CEO charjohn@cmchd.org or call at (208) 382-4242 Cascade Medical Center | 402 Lake Cascade Parkway | Cascade, ID 83611