Colorado Nurse - May 2018


The Official Publication of the Colorado Nurses Foundation in partnership with the Colorado Nurses Association

Volume 118 • No. 2 • May 2018

Quarterly publication direct mailed to approximately 82,000 RNs and LPNs in Colorado


From the Desk of

the CNF President

Colorado Nurses

Association President...

Professional Nursing


A Call to Action: Rethink, Refocus and Restructure

Sara Jarrett, EdD, MS, CNS, RN

President, Colorado Nurses Foundation

It is time to act on the issues of duplication, overlap

of mission and other activities of the many numbers

of professional nursing groups. The profession has a

responsibility to its members to provide meaningful

opportunities for professional engagement beyond the

workplace. It is up to the members of the profession to

become the leaders through formal professional groups

to continue support, review and development of such

professional documents as the Code of Ethics, the Social Sara Jarrett

Policy Statement, The Standards of Practice, Specialty

Practice Standards and many others.

CNF President continued on page 3

What is the Colorado Nurse

Practice Act?

Donna Strickland, MS, RN, PMHCNS-BC, CSP


You’ve probably heard by now that Colorado’s Nurse

Practice Act will go into Sunset Review in 2020. Before we

talk about Sunset (in the next article), let’s first look at just

what a Nurse Practice Act is all about.

More than 100 years ago, state governments

established boards of nursing (BONs) to protect the

public’s health and welfare by overseeing and ensuring the

safe practice of nursing. The practice of nursing is a right

granted by the state of Colorado to protect those who Donna Strickland

need nursing care.

Today, BONs regulate and oversee nursing practice by enforcing the nursing laws

of Colorado.

BON structures and decision-making powers and authority are unique for each

state. Individuals who serve on a BON are appointed or elected to their position.

State law dictates the membership of the BON, which typically includes: RNs, LPNs,

APRNs, and Consumers. In Colorado, BON members are Governor appointees.

Responsibilities of a BON vary from state to state but generally include:

• Enforcing the state’s nurse practice act (NPA) and nurse licensure

• Accrediting or approving nursing education programs

• Developing practice standards

• Developing policies, administrative rules and regulations and

• Addressing violations of the NPA (one example, is that every felony should be

reported to the BON)

Happy National Nurses Week!

May 6–12, 2018

Every nurse in the U.S. is responsible for knowing the state’s NPA and regulatory

requirements for nursing for every jurisdiction in which they hold a license. Since

laws, rules and regulations may change over time, it is also found on each BON’s


CNA President continued on page 2

current resident or

Non-Profit Org.

U.S. Postage Paid

Princeton, MN

Permit No. 14

Executive Director’s Column ................3

Government Affairs & Public Policy Committee ...4

Peer Assistance ..........................5

New Graduate Corner .....................6

Friends of Nursing 2017 Scholarship Awards ...7

Colorado Nurses Foundation Honors

Nightingale Luminaries ..................8-9


CNA Legislative Efforts 2018 .............10-11

Care Without Assumption: A Conceptual

Framework for Transgender Nursing Care ... 12

Faith Community Nursing in Colorado .......15

District & Special Interest Group Reports ...16-17

American Nurses Association ..............18

Medical Marijuana ....................... 19

2 • Colorado Nurse | May 2018

The Official Publication of the Colorado Nurses Foundation in partnership with the Colorado Nurses Association

CNA President continued from page 1

A violation of the NPA is serious and can result in a

complaint being filed with the BON. Some examples of

violations of NPA are negligence, impaired practice by

drugs or alcohol or a mental health condition, stealing

from a patient/client, including medications, providing

treatment or care that should be provided only by a

physician or APRN, falsifying records, boundary issues,

including abusing a patient physically or sexually and

involvement in criminal conduct. This is not an exclusive

list. The BON utilizes its authority to decide whether

misconduct or safe practice has occurred and what action

should be taken. Violations are taken very seriously since

they can put patients at risk. This is why every nurse is

responsible for understanding his/her scope of practice

and other requirements outlined in the law.

Nurse Practice acts in each state are laws that define

relationships of the nurse and “scope of practice.”

The range of activities and services as well as the

qualifications for practice. The acts are intended to

protect patients from harm as a result of unsafe or

incompetent practice, or unqualified nurses.

When was the last time you read your NPA?

I’m guessing you were given a copy of the Act when

you started nursing school. Be honest now, did you

ever read it? I would guess that most of you did not

see a need. After all, it’s not like it’s particularly fun or

easy to read all that legal jargon. There are 127 pages

of rules and regulations attached to the Nurse Practice

Act in Colorado.

But the truth is, if you are going to be successful as

a nurse, (and one that others look to as an example)

you’ll need to know what is your NPA. Did you

know that there are now two states that requires

jurisprudence examinations prior to licensure? That’s

at least one way to get people to read and understand

their Nurse Practice Act. Wondering if you live in one of

the two states? See the answer below!

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In addition to Scope of Practice, a NPA details

information about licensure requirements, including

initial licensures, renewing or reestablishment of


Most nursing students and some nurses are

surprised to learn the purpose of the NPA is to protect

the public. So, compassion and knowledge go hand

in hand. If you think about it, if someone calls him or

herself a nurse, then she/he would have the education

and training required to perform the requirement

associated with being “a nurse.”

To shine on the job, it’s critical to know how to

prevent and navigate disciplinary issues. And, this gets

significant attention in any NPA.

• Grounds for discipline – Did you know that

forgetting to renew your license on time or

defaulting on a student loan are grounds for


• Investigating a complaint filed against a nurse.

Did you know that anyone can file a complaint

against a nurse?

• Board hearing process – Did you know that

a nurse who is the subject of a complaint is

provided the opportunity for due process (which

is guaranteed by the U.S. Constitution?

The first person who said, “ignorance is bliss” was

probably not a nurse because not knowing information

in your Nurse Practice Act can result in disciplinarian

action against your license, ranging from reprimand to

suspension, or even revocation.

So, are you ready to read your NPA? Don’t know

how to find your NPA?

Of course, you can locate at the Colorado

Department of Regulatory Affairs website under

Nursing ( Another

way is to go to the National Council of State Boards of

Nursing (NCSBN) site (

which has a map with contact information (LINK) for

every Board of Nursing (BON); use the BON website to

locate your Nurse Practice Act and to find information

about Colorado’s. Your scope of practice is governed

by the state in which your patient lives, if you do


Answer to question in first paragraph: Texas and

Kentucky law now require taking (and passing) a nurse

jurisprudence examination prior to licensure.

Nurses in Colorado are among the best in the

country and work hard to practice safely and

competently. Your BON is working diligently to support

nurses in this effort.

The next Colorado Nurse will talk about the

upcoming Sunset Review of the NPA.

COLORADO NURSE (ISSN-8750-846X) is published 4 times annually,

February, May, August, and November, by the Arthur L. Davis Publishing

Agency, Inc. for the Colorado Nurses Foundation, 2851 South Parker Rd,

Ste 1210, Aurora, CO 80014; Mailing: P.O. Box 3406, Englewood, CO


Subscription may be purchased for $20 per year, $35/2 years, $25 per year

for foreign addresses.

For advertising rates and information, please contact Arthur L. Davis

Publishing Agency, Inc., 517 Washington Street, PO Box 216, Cedar Falls,

Iowa 50613, (800) 626-4081, CNF and the Arthur L.

Davis Publishing Agency, Inc. reserve the right to reject any advertisement.

Responsibility for errors in advertising is limited to corrections in the next

issue or refund of price of advertisement.

Acceptance of advertising does not imply endorsement or approval by the

Colorado Nurses Foundation of products advertised, the advertisers, or

the claims made. Rejection of an advertisement does not imply a product

offered for advertising is without merit, or that the manufacturer lacks

integrity, or that this association disapproves of the product or its use. CNF

and the Arthur L. Davis Publishing Agency, Inc. shall not be held liable for

any consequences resulting from purchase or use of an advertiser’s product.

Articles appearing in this publication express the opinions of the authors;

they do not necessarily reflect views of the staff, board, or membership of

CNF or those of the national or local associations.

Colorado Nurses Foundation wants to hear from you and welcomes

letter to the editors. Correspondence may be sent to Colorado Nurses

Foundation, 2851 South Parker Rd, Ste 1210, Aurora, CO 80014;

Mailing: P.O. Box 3406, Englewood, CO 80155-3406; email, info@

To submit an article for publication, please consider the following


1. Topic is current and relevant to RN practice.

2. 500 word limit

3. Individuals may submit articles for consideration by emailing

Material is copyrighted 2015 by the Colorado Nurses Foundation and may

not be reprinted without written permission from CNF.

Co-Editors: Eve Hoygaard, MS, RN, WHNP (30)

M. Colleen Casper, RN, MS, DNP (16)

CNA Executive Director:

Colleen Casper, RN, MS, DNP



President: Sara Jarrett

Vice President: Margaret Mulhall

Secretary: Carol O’Meara

Treasurer: Carol Brookshire


Lola Fehr, Eve Hoygaard, Judith Burke,

Linda Satkowiak, Norma Tubman



President: Donna Strickland (31)

Vice President: Susan Moyer (20)


Secretary: Carol O’Meara (30)

Treasurer: Linda Stroup (20)


Region I Director:

Region I Director:

Laura Rosenthal (30) Kathy Shaw (30)

Region II Director:

Region II Director:

Hilary St. John (3) Lori Rae Hamilton (4)

Region III Director:

Region III Director:

Sandie Nadelson Mary Ciambelli (31)



Ingrid Johnson (16) Jody DeStigter (9)

SIG #2:

DNA #3:

DNA #4:

DNA #5:

DNA #6:

DNA #7:

DNA #9:

New Graduate Director: Adam Diesi (16)


Colleen Casper (Liaison)

Anne Zobec, Colorado Springs

Kathryn Carpenter, Model, CO

Contact Sandi Nadelson at

Charlotte LeDonne, Alamosa, CO

Contact Colleen Casper at

for additional information

DNA #12: Contact Colleen Casper at

for additional information

DNA #16: Christine Schmidt, Denver, CO

DNA #20: Annette Cannon, Lakewood, CO

DNA #23: Contact Colleen Casper at

for additional information

SIG #30:

SIG #31:

Afton Williamson, Denver, CO

Karen Lyda, DNP, PMHNP, RN

To contact any person listed above, please use the

CNA/CNF office numbers/address/email address.

CNA Contact Information:

Ph: 720-457-1194 • Fax: 303-200-7099


CNF Contact Information: Ph: 720-457-1004


The Official Publication of the Colorado Nurses Foundation in partnership with the Colorado Nurses Association May 2018 | Colorado Nurse • 3

Executive Director's Column

Story of Advocacy in Action

Colleen Casper, DNP, RN, MS

At the 2017 Annual DNA 16 Sponsored Legislative

Dinner, Colorado State Senator Irene Aguilar (District

32) announced an interest in talking with any RN’s who

are willing to work with her on nursing workforce and

staffing issues in critical care. Senator Aguilar shared

that constituents of hers had brought to her concerns

of critical care nurses not having enough staff to

consistently deliver the surveillance and interventions

required for safe patient care.

In follow up, in May of 2017, myself as Executive

Director of Colorado Nurses Association (CNA) and as

a previous critical care nurse and hospital administrator,

partnered with a current critical care RN member of

CNA, and the CNA lobbyist Gil Romero to meet with

Senator Aguilar. What followed was a yearlong series

of meetings with the above-mentioned individuals

along with representatives from Colorado Hospital

Association (CHA) and the Colorado Department

of Public Health and Environment (CDPHE). CHA

represents Colorado hospitals and health care systems,

and CDPHE licenses facilities that provide acute, long

term, assisted living, and home based care.

Initially, we explored the potential of a legislative

approach, i.e. a nurse-staffing bill. We were cognizant

of many factors that could influence the success of

that effort. Some of those included known workforce

shortages, particularly in rural areas, and, Colorado’s

history of resisting mandated nurse:patient ratios,

including a stakeholder based process in the 2008

Legislative session. Those efforts resulted in a pilot study

to understand how hospital based RN providers define

“involvement in staffing decisions” and the correlation

of that process with patient and staff outcomes

(Houser, et al, 2012, JONA, 42:7/8,pp375-382).

We determined that this was not a good time for a

successful Colorado legislative bill regarding staffing.

Yet, we persisted.

CNA recognizes that nurse staffing is not a one size

fits all. We also recognize the critical role RN’s play

in assuring effective monitoring and early detection

of real or potential complications, as well as timely

coordination of essential care provided at the bedside

(critical care, home care, nursing home care, medical

surgical care). For many years, we have said there is not

enough evidence to support mandating nurse staffing

and now we know better. We know that patient

morbidity, mortality, and hospital economic success is

dependent on competent and adequate RN staffing.

CNA is interested in assuring that the conversation

of safe staffing in Colorado remains current and

includes RN’s who are closest to the patient as well as

administrative and regulatory leaders.

As we reviewed the key wins from the 2008 efforts,

we were reminded of the legislative mandate (SB08-

196) for the Hospital Quality Report Card that was to

include standardized reporting of nationally recognized

Nurse Sensitive Indicators. (See article in this issue by

Elizabeth Adle) We knew we needed useful data to

support meaningful conversation and solutions.

Recently, CNA, CHA, and CDPHE met at the

Colorado State Capitol with Senator Aguilar to discuss

the possibility of care providers of all disciplines

being able to report “near misses” in care delivery

related to quality and safe staffing. We had a shared

knowledge of the CDPHE “complaint line.” Our

discussion highlighted that, in fact, there is currently a

method to confidentially report staffing, or any work

environment, related concerns that put patients at risk.

CDPHE leadership recommended that we collaborate

on a strong and formal communication of the available

existing systems. Further, CDPHE shared their plan

to then report those complaint trends annually to the

CDPHE governing board, the Colorado Board of Health.

CNA would like to thank Senator Aguilar, CHA

staff Gail Finely, CDPHE staff Randy Kuykendahl and

Larry Wolk, MD, MSPH, and Gil Romero in advising,

supporting and advancing this conversation. Where

we started in this process is different from where we

ended, not uncommon in the world of policy and

politics. The outcomes achieved are the result of

persistent and collaborative efforts to work towards a

solution. We insisted on achieving a change that was

focused on patient safety and would support increasing

awareness and action for responsible RN staffing.

Please watch for more detailed communication

from the Colorado Department of Public Health and

Environment regarding the utilization of the “near

miss” reporting line.

In the event you want to make a report, please do

so at this link:


CNF President continued from page 1

As the profession looks to its future, I would like to

offer the following points for consideration. First, we

should consider the focus and mission of organizations

to include advocacy and professional citizenship, clinical

practice and certification, education and accreditation,

and workforce issues. Second, how do we best engage

members of the profession for involvement and work in

multiple geographic areas: international, national, state

and local? Third, the economics related to professional

organizations – the cost of membership for individuals

and the expense to run a viable organization. Fourth,

the profession and its groups must also consider

how to best use social media in any re-organizational

activities. Additional information of significance is to

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acknowledge the sheer size of this profession in the US

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The questions now before us include: How and

where do we start? What should be the process? Who

should provide a plan? How do we best communicate

to the entire community of nurses in the US?

There are a lot of dots to be connected…I hope that

we (the profession) can find our way through the maze

of complexity to some new and updated approaches

to this topic. The largest profession needs a much

greater percentage of its members to be involved

and committed to the support and survival of the

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4 • Colorado Nurse | May 2018

The Official Publication of the Colorado Nurses Foundation in partnership with the Colorado Nurses Association

Government Affairs & Public Policy Committee

Highlights from the 2018 Colorado Legislative Session

Angela Petkoff, BSN, RN

MSN-AGNP Student at University of Colorado -


Colorado Nurses Association’s Government Affairs

and Public Policy (GAPP) committee has been hard

at work since January. Lawmakers have proposed a

number of significant nursing and healthcare-related

bills in this year’s legislative session. This article presents

some of the legislation GAPP has focused on through

mid-March 2018, when this article was written and


Most significantly, the Enhanced Nurse Licensure

Compact (eNLC), Senate Bill 27 (SB18-027), was a

major success at the start of the session. CNA and

GAPP advocated for the bill, and it whipped through

both chambers with swiftness rarely seen in the

legislature. SB18-027 arrived on Governor John

Hickenlooper’s desk a mere seven days after it was

introduced, and it was the first bill he signed into law

this session. The quick adoption of the eNLC prevented

gaps in licensure for RNs holding a multistate license.

The GAPP committee would like to thank everyone

who reached out to their legislator to ask for their

support and to the Senate and House sponsors: Sen.

Smallwood, Sen. Todd, Rep. Kraft-Tharp and Rep.

McKean. For additional information on the eNLC

and how it may impact your RN license, go to: www.

Other bills GAPP has supported

this session include:

SB18-024: Expand Access Behavioral Health Care

This bill provides appropriates money from

the marijuana tax cash fund to develop a loan

repayment and scholarship program for behavioral

health care providers working in underserved areas.

HB18-1136: Substance Use Disorder Treatment

This bill utilizes money from the marijuana tax cash

fund to increase access to inpatient and residential

substance use disorder services by adding these

services to the Colorado Medical Assistance


SB18-022: Clinical Practice for Opioid Prescribing

This bill contains measures to increase safety

in opioid prescribing including limiting amount

of opioids that may be prescribed in particular

instances, requiring query of the prescription drug

monitoring program upon prescribing first refill and

allowing for opioids to be prescribed electronically.

HB18-1003: Opioid Misuse Prevention

This bill establishes an opioid and other substance

use disorder study committee.

HB18-1006: Infant Newborn Screening

This bill updates Colorado’s current newborn

screening program by requiring more timely

newborn hearing screening.

HB18-1094: Children and Youth Mental Health Act

This bill extends indefinitely the ‘Child Mental Health

Treatment Act’ and renames it the ‘Children and

Youth Mental Health Treatment Act’ with some

revisions to the act. This bill allows a parent or

guardian of a child or youth who is not eligible for

Medicaid to continue to seek mental health services

for the child or youth without unwarranted child

welfare involvement.

More highlights from the 2018 legislative session will

be shared in the August issue of the Colorado Nurse. If

you would like to be informed sooner or receive more

detailed information, check out the GAPP online forum

on the CNA website,

Save the Date

Be sure to check CNA Calendar for All Activities at

CO Division of Youth Services is

expanding our nursing services!

We are now recruiting 35+

additional RNs and NPs.

Check the state of CO website for job postings at

Peggy Baikie

Medical Operations Coordinator

P 303.916.1277 |

2018 ANA National Nurses Week May 6-12, 2018

Nurses Inspire Innovate Influence

Free Webinar

Reach Out to Colorado Nurses Event –

CNA Wants to Hear from You

May 2, 2018 Medical Center of the Rockies

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4pm – 8 pm

Call for Nominations Colorado Nurses

Association Board of Directors

Please check Colorado Nurses Association website for:

Bylaws with description of Board Roles

District & Regional Map for Visual of

Director Representative Areas

Links for Nomination Submission

Submission due date July 31, 2018

Positions Open:


(1 year as President Elect and 2 Years as President)

Vice President (2 year term)

Region 1 Director (2 year term)

Region 2 Director (2 year term)

Region 3 Director (2 year term)

Director At Large (2 year term)

Nominating Committee (2 year term)

Colorado Nurses Association Annual

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The Official Publication of the Colorado Nurses Foundation in partnership with the Colorado Nurses Association May 2018 | Colorado Nurse • 5

Peer Assistance

Interactive App Teaches Skills for Conversations about

Alcohol and Marijuana Use

Valley. Recognizing the importance of the simulation’s

message, media outlets have chosen to feature the

campaign in their publications including Westword, The

Mountain Mail, and the Colorado Springs Gazette.

The second round of the media campaign began in

January 2018 and ran through the end of March. This

round focused on the following counties: Logan, Las

Animas, La Plata, and Eagle.

For more information on the One Degree campaign

and to download the app, please visit www.

In September 2017, Peer Assistance Services, Inc.

launched a statewide public awareness campaign

called One Degree. Available online and as a mobile

application, the One Degree campaign provides

Coloradans with a free, easy to use, platform to

learn how to have conversations about alcohol

and marijuana with friends, family members, and

coworkers. The goal of One Degree is to empower its

users to talk to each other about making small changes

to improve their health.

Twenty-five percent of Americans drink at levels

that could lead to health or other problems – yet,

most people who drink too much do not have a

serious alcohol use disorder – or what we used to call

“alcoholics.” Talking with those around us about use

of alcohol and other substances can help prevent those

disorders, avoid disease and injury, improve family and

work life, and promote overall well-being.

Peer Assistance Services, in partnership with

application developers, Kognito Solutions, has

been able to bring this campaign to 7 counties in

Colorado through paid media. Employing strategies

such as radio ads, bus tails, print, and social media

has made the One Degree campaign a success.

Since its inception, the campaign has been viewed

over 24 million times statewide. Although the first

round of paid advertisement was concentrated in

Denver, Otero, and Morgan counties, the campaign

reached many other counties, such as El Paso, Larimer,

Arapahoe, Broomfield, and parts of the San Luis

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6 • Colorado Nurse | May 2018

The Official Publication of the Colorado Nurses Foundation in partnership with the Colorado Nurses Association

The Dynamic Voice of Colorado Nurses Was Heard and Nurses Need

to Continue to Use Their Voices to Influence Health Care Policy

Patricia Abbott RN

CNA & SIG 30 Member

Thank you to all the nurses in Colorado who used

their impassioned voices and commitment to patient

safety to convince legislators, Democrat and Republican

of the need to support SB 18-027, Enhanced Nurse

Licensure Compact (eNLC). When signed by Governor

Hickenlooper, it became the first bill to be passed into

law in the 2018 session and one of the fastest bills to be

passed in the Colorado Legislature. The voice of Colorado

nurses helped to ensure the bill was passed. Your

commitment to ensure public health and safety showed

legislators the impact and strength of a unified nursing


On the American Nurses Association website, it is

stated that nurses offer a unique and expert perspective

that influences every aspect of the health care system.

Nurses do have a key voice in ongoing efforts to improve

public health. The timely passage of SB 18-027 is an

example of what the nursing profession is able to offer

the health care system.


This ‘show of strength’ to advocate for patients and

safe care is a commitment that needs to be ongoing.

Throughout the 2018 Legislative Session there have been

many bills that directly affect patient care and safety. It

is empowering to see that nurses, throughout the state,

are contributing to policy discussions using the Colorado

Nurses Association (CNA) on-line forum.

“If Not Now, When?” was an article in the Colorado

Nurse, February 2018, submitted by Sara Jarrett EdD, RN.

In this thoughtful reflection, Dr. Jarrett stated, “Nursing

needs to acknowledge and act with a sense of urgency

to address the ever changing healthcare and nursing


Colorado nurses did act with a sense of urgency and

positively influenced the passage of SB 18-027. We must

keep up this momentum and continue to be engaged

in public policy that affects so much of what we do

as a profession. Now is the time for nursing to use its

strength in numbers, its expertise from their frontline

roles and use their voices to positively influence Health

Care Policy.

Take A-Ways:

- There is strength in numbers and there are over

80,000 nurses in Colorado. The strength of the

nursing profession has shown it does have impact

on legislation and this needs to be ongoing.

- The voice of nursing does influence health policy.

- Value the expertise you have as individual nurses

and acknowledge how valuable that is to all

aspects of the health care system.

- Take some time each week to be engaged in

the discussions regarding health care policy on

the CNA on-line forum. You will find this to

be enriching for yourself and it is vital to the


- The State of Colorado, legislators and most

importantly patients, need your insight and

wisdom, which can only be heard when you use

your voices.

Nursing Sensitive Measures in Colorado

Join your peers and the members of Colorado Nurses

Association in shaping the nursing care available in the

State of Colorado!

Elizabeth Adle, MAT, BSN, RN, NEA-BC

Colorado Hospital Association (CHA), which

represents and serves more than 100 hospital and

health systems throughout the state, is committed to

providing relevant and meaningful nursing sensitive

measures data. With that in mind, the Association

is currently working with Colorado nursing sensitive

measures and has upcoming plans to remain current

with evidence-based best practice.

In 2008, Governor Bill Ritter signed into law Senate

Bill (SB) 08-196 concerning the inclusion of nursing

sensitive quality measures in the comprehensive hospital

information system. The nursing sensitive measures

were implemented to address nurse satisfaction as well

as patient outcomes influenced by nursing care. The

Colorado measures include: skill mix, nursing care hours

per patient day, voluntary turnover, nursing education

and certification, patient falls prevalence, patient falls

with injury and the practice environment scale (PES)

that measures scores for the following subscales: nurse

participation in hospital affairs; nursing foundations for

quality of care; nurse manager ability, leadership and

support of nurses; staffing and resource adequacy; and

collegiality of nurse-physician relations.

SB 08-196 authorized the Colorado Department

of Public Health and Environment (CDPHE) Executive

Director to designate CHA with managing the data

collection and public reporting of the nursing sensitive

measures for hospitals with 100 or more licensed beds.

In Colorado, there are 30 hospitals that meet this


At the 10-year mark of the Association’s work to

develop Colorado’s nursing sensitive measures, CHA

believes it is essential to evaluate current evidencebased

practice to ensure the measures reported are

indicative of nursing practice and meaningful to those

viewing the data. This data is currently available to the

public via the Colorado Hospital Report Card site.

The Association’s plan of action includes asking

some of Colorado’s major health systems to designate

an appropriate direct-care nurse to assist CHA in

reviewing current best practices and research and

develop recommendations for improvement. As

defined in SB 08-196 a “Direct-Care Nurse means a

registered nurse who is engaged in direct patient care

responsibilities in an inpatient hospital unit setting for

more than 50 percent of his or her working hours.”

Additional voting members will include two at large

representatives from the Colorado Nurses Association,

a CDPHE representative and a registered nurse and

project manager from CHA. Meetings will be open to

the public. CHA also plans to include two non-voting

members: a nurse researcher and a graduate nursing

student to assist with research and analysis.

The focus will be two-fold: to evaluate the current

practice including the measures utilized and data

obtained and delineating recommendations and

plans including specific and pertinent nurse sensitive

measures as well as creating an annual report to be

submitted to CDPHE and the Board of Health.

Questions can be directed to Gail Finely, CHA Vice

President Rural Health & Hospitals, at gail.finley@cha.

org or 720.330.6027.

New Graduate

RN Corner

Early Career Nurses

Adam Diesi, BSN, RN

CNA Board Member – Representative Recent


Greetings New Nurses and Happy Nurses Week! This

week we celebrate you and your dedication to Inspire,

Innovate, and Influence! Congratulations on choosing

a career that has the power to touch the lives of so

many. You have joined the ranks of 3.6 million other

nurses nationally and over 80,000 nurses in Colorado.

The American Nurses Association and The Colorado

Nurses Association are here to assist you with your

professional development needs as you move forward

in your new career as a nurse. If you have questions

or concerns, please do not hesitate to reach out

to our team or connect with us on social media.


Be Well,


Announcing Career Opportunities

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Apply online at

CoreCivic is a Drug Free Workplace & EOE - M/F/Vets/Disabled.

State of Wyoming, Department of Health, Aging Division,

Healthcare Licensing and Surveys is recruiting for

Lead Health Facility Surveyor

Recruitment ID: HSHP10-07568

You will serve as a Lead Health Facility Surveyor for Non -Long Term Care,

within the Health Care Surveillance Branch, State Office of Healthcare

Licensing and Surveys, Wyoming Department of Health, supervising

health facility surveyors in conducting surveys and investigating

complaints in accordance with Wyoming State Statutes and agreement

with the federal Centers for Medicare and Medicaid Services (CMS).

For more information or to apply online go to:

and search HSHP10.

Open until filled. EEO/ADA Employer.

The Official Publication of the Colorado Nurses Foundation in partnership with the Colorado Nurses Association May 2018 | Colorado Nurse • 7

Friends of Nursing

2017 Scholarship Awards

Cris Finn, PhD, RN, FNP, FNE, CFC

Families, Friends of Nursing (FON) members and

supporters celebrated with 21 nursing students as they

received FON scholarship awards. The undergraduate

and graduate nursing scholars represented nine

colleges and schools of nursing in Colorado. Rick

Crandall served as emcee for the event while Ruth

O’Brien, Chair of the FON Scholarship and Grants

Committee, presented scholarship awards. A special

recognition to Caring for Colorado was awarded. A

total of $55,000 in scholarship monies was awarded,

raised in the past year by donations to FON, special

events, investments and member dues. Two new

scholarships were presented in memory of Joseph and

Ann Pfost by their daughter, Greta Pollard, and another

honoring Don Pollard by his wife, Greta. The overflow

crowd luncheon was held in the ballroom of Lakewood

Country Club on April 8. For more information please

contact Cris Finn, President FON,

Sigma Theta Tau


Alpha Kappa Chapter at

Large Scholarship Awards

Thank you to all who celebrated and honored

our scholarship recipients this year. We awarded

$9,000 in scholarships to the following students:

Colorado Christian University

• Susan Adamson – CCU BSN Scholarship

• Rikki Haskins – CCU BSN Scholarship

• Tiffany Parsons – CCU BSN Scholarship

Adams State University, Alamosa

• Jessica Worker – Olga S. Miercort Scholarship

Colorado Christian University, Denver

• Susan Adamson – Georgia Imhoff

Memorial Scholarship

• Ana Nielson – Friends of Nursing Scholarship

Colorado State University, Pueblo

• Terra Chambers – Joseph & Ann Pfost

Memorial Scholarship

• Stacie Gray McCue – Friends

of Nursing Scholarship

• Olivia Navarro – Wayne T. “Dusty”

Biddle Memorial Scholarship

Colorado Mesa University, Grand Junction

• Lexie Sutcliffe – Ruth Harboe

Memorial Scholarship

Metro State University of Denver

• Laura Batch – Friends of Nursing Scholarship

• Elizabeth McDonald – President’s Scholarship

• Rita Zerfoss – Fern Howard Award

Regis University, Loretto Heights

School of Nursing, Denver

• Jenna Euler – Friends of Nursing Scholarship

• Toni Johnson – Verda Richie Memorial Scholarship

• Mirabel Usongo – FON/Leila B. Kinney Scholarship

University of Colorado, Helen & Arthur Johnson/

Beth-El College of Nursing, Colorado Springs

• Isabel Kirk – Donald Pollard Scholarship

• Elizabeth Schneider – Friends

of Nursing Scholarship

• Kate Wogan – St. Lukes’s Alumnae Scholarship

University of Colorado, College of Nursing, Denver

• Jill Bastman – Viola Baudendistel

Memorial Scholarship

• Kimberly Lowdon – Georgia Imhoff

Memorial Scholarship

• Amy Lynde – Greta Pollard Scholarship

University of Northern Colorado, Greeley

• Claudia Gomez Betancourt – Shirley Rarey

Memorial Scholarship

• Alexandra Lessem – Josephine Ballard/

Presbyterian Scholarship

Regis University, Loretto Heights

School of Nursing

• Mackenzie Laird – Margaret Metzger


University of Colorado, College of Nursing

• Jessica Anderson – M. Jean Watson


• Caitlin McCarthy – Henrietta Loughran


• Morgan Nestingen – Henrietta Loughran


• Ann Wislowski – Henrietta Loughran


Congratulations to these well deserving nursing


If you have questions about scholarships for next

year please contact the committee chair Dr. Cris

Finn at

8 • Colorado Nurse | May 2018

The Official Publication of the Colorado Nurses Foundation in partnership with the Colorado Nurses Association

Colorado Nurses Foundation Honors

Nightingale Luminaries

Carol O’Meara

Continuing the tradition of recognizing excellence in

nursing professional engagement and citizenship, the

Colorado Nurses Foundation will honor 52 outstanding

nurses at the 33rd Annual Nightingale Luminary Awards

gala to be held Saturday, May 12, 2018 at CU South.

Nurses in Clinical Practice and Nurses in Administrator,

Educator, and Researcher of Non-Traditional Roles are

nominated for Advocacy, Innovation and Leadership.

Meet the luminaries for 2018:



Elyse Bueno is a Nurse Manager at University of

Colorado Hospital nominated for her innovation in

creating an ICU Procedure Team to improve the quality,

safety and continuity of patient care for patients needing

a tracheotomy or PEG Tube Insertion in the ICU.

Andrea Burch is Vice President and Chief Nursing

Officer at Lutheran Medical Center. She is nominated

for her leadership in improving the patient experience as

well as improving employee engagement.

Deb Center is Education Program Director and

Lead Coach at the Colorado Center for Nursing

Excellence. She is nominated for leadership in a project

designed to develop highly functioning and impactful

interprofessional teams at Federally Qualified Health


Lauren Cittadino is a Critical Care Clinical Nurse

Specialist at Swedish Medical Center nominated for

innovation in improving the outcomes of patients with

aneurysmal subarachnoid hemorrhage through the

creation of a multidisciplinary protocol for the prevention

and treatment of cerebral vasospasm.

Laura-Anne Cleveland is Director at Swedish

Medical Center Southwest ER. She is nominated for

advocacy in serving with the Colorado Disaster Recovery

Team in Texas, Puerto Rico and the US Virgin Islands

after a series of four hurricanes.

Deborah Fleming is a Nurse Manager at UC

Health Memorial Hospital nominated for innovation

in decreasing wait times and improving the patient

experience and employee engagement in the Outpatient

Oncology Infusion Clinic.

Cassondra Franco is Public Health Nurse Clinical

Coordinator at Chaffee County Public Health nominated

for advocacy for mothers needing breastfeeding

support. She created the Healthy Start program to

address the needs of these mothers and their families.

Katherine Glass is Care Coordinator and Clinic

Supervisor at Valley View Hospital. Kati is nominated

for advocacy in coordinating care for high-risk

cardiovascular patients during transitions of care.

Jacinda Heintzelman is an Assistant Professor of

Nursing at CSU Pueblo. She is nominated for innovative

research to study the effects of cannabis use during

pregnancy on fetal development and pregnancy


Nate Hinze is an educator with UC Health Life

Line Critical Transport nominated for innovation in

developing creative simulations for training Life Line


Brianna Hoffner is Assistant Professor, Lead

Advanced Practice Provider, and Nurse Practitioner in

Medical Oncology at University of Colorado School

of Medicine. She is nominated for her leadership in

achieving the goal of providing patients with same day

access to care for symptom management relating to

their cancer treatment utilizing a Nurse Practitioner led


Laura Johnson is Associate Chief Nurse, Inpatient

Mental Health, Grand Junction Veterans Health Care

System. She is nominated for innovation in instituting a

protocol for proactively identifying veterans at risk for

suicide related to chronic pain.

April Kendall is a Senior Manager at East Morgan

County Hospital in Brush, Colorado nominated for

her advocacy in the development of a program to

provide information and education specific to Women’s

Healthcare needs.

Sylvia Kurko is Manager of Education Resources at

Penrose-St. Francis Health Services. She is nominated for

advocating for Penrose-St. Francis associates and nursing

students to obtain needed training in the EPIC electronic

medical record system.

Sarah Lancaster is Clinical Nurse Manager in

the Emergency Department at St. Mary’s Hospital

Medical Center in Grand Junction. She is nominated for

leadership in making the Provider In Triage process a

reality at St. Mary’s Hospital to improve patient care in

the Emergency Department.

Kathleen Martinez is Clinical Policy Oversight

Manager and Interim Director of Nursing Innovations

and Outcomes at Children’s Hospital Colorado. She

is nominated for innovation in creating a Policy and

Procedure on line management system to make clinical

policies easy to find, easy to read and easy to follow.

Kristen Oster is a Perioperative Clinical Nurse

Specialist at Porter Adventist Hospital. She is nominated

for leadership in reducing pressure injury occurrences in

the head and neck surgical population.

Victoria Owens is Vice President, Emergency

Services, Swedish Medical Center nominated for

advocating for emergency department patients by

working to change pain management and narcotic

prescribing practices in the ED.

Christine Peyton is Clinical Practice Specialist at

Children’s Hospital Colorado. She is nominated for

advocating for Pediatric and Young Adult Congenital

Heart patients in addressing their palliative care needs.

Brandi Schimpf is Mobile Stroke Program Manager

at University of Colorado Hospital nominated for

creating an innovative program to decrease time from

onset of stroke symptoms to treatment by bringing

advanced technology directly to the patient.

Kierra Shaffer is Clinical Nurse Manager, Senior

Behavioral Health, at Lutheran Medical Center. She is

nominated for her advocacy of aging behavioral health

patients, including those who have been incarcerated

and have either probation or pending parole.

Mary Shry is Case Management Supervisor at Mercy

Regional Medical Center in Durango. She is nominated

for her advocacy in assisting an auto accident victim and

his family with a difficult situation.

Lou Ann Cheslock Skinner is a Nurse Home Visitor

with the Valley Wide Health Systems Nurse Family

Partnership Program in Alamosa. She is nominated for

advocating for first time mothers and their children.

Charee Taccogno is Chief, Utilization Management,

US Air Force Academy. She is nominated for leadership

in improving access to patient care by partnering

with clinic staff, solving problems, and re-engineering

processes for patient referrals.

Brenda Tousley is Senior House Manager at Banner

Fort Collins Medical Center. She is nominated for her

leadership in improving mortality associated with sepsis

and ensuring that national standards are being met.

Linda Young is Director of Clinical Services at

Mercy Regional Medical Center in Durango nominated

for leadership in obtaining equipment and providing

education to improve the care of morbidly obese

patients and to reduce injuries to staff caring for these



Jessica Anderson is Director of the Center for

Midwifery and Assistant Professor at University of

Colorado Denver College of Nursing. She is nominated

for her leadership in creating an active Colorado

nurse midwifery affiliate of the American College of

Nurse Midwifery with the goal of strengthening nurse

midwifery statewide and meeting the needs of women

and their families.

Emily Bankhead is a Nurse Practitioner and Certified

Diabetes Educator at Evans Army Community Hospital

in Fort Carson, CO. She is nominated for her advocacy

in improving the care of diabetic patients through

development of Team Based Diabetic Management


Kristen Blair is a Labor and Delivery Nurse and

Perinatal Bereavement Coordinator at Parkview Medical

Center in Pueblo. She is nominated for her advocacy of

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Honor a Mentor for Colorado Nurses

Foundation Scholarship Fund

The Colorado Nurses Foundation (CNF) currently

has scholarships that are awarded every year. Many

of the scholarships are designated and other awards

are open to “all” who meet the basic requirements

that are available on our website at www.

We would like to encourage you to consider

making a donation in honor of a nurse, a nurse

mentor, or a nurse who has had a major influence

in your career as a nurse. Every nurse can identify

an exceptional individual(s) who has served their

development in some way. The CNF encourages you

to take time and reflect on your career. Who are those

individuals who helped you develop, find that niche

role or job, challenged you to be better and stronger

as a nurse? We invite you to recognize your mentors

by making a donation to this scholarship fund.

All names of mentors and mentees will be shared

in the Colorado Nurse. Donation amounts will

remain private.

To honor your nurse mentor and make a

donation in her or his name, please visit the website and click

on the “About” button. The donation information

can be found at the bottom of that page. If you

would like to mail CNF a check, please note your

mentor name(s) and send to CNF, P.O. Box 3406,

Englewood, CO 80155.

The Official Publication of the Colorado Nurses Foundation in partnership with the Colorado Nurses Association May 2018 | Colorado Nurse • 9

Colorado Nurses Foundation Honors

Nightingale Luminaries

women, friends and family experiencing perinatal loss

through establishing processes and providing knowledge

and support to hospital staff.

Shelly Cannon is a Staff Nurse in the Post

Anesthesia Care Unit at Lutheran Medical Center. She

is nominated for advocating for the safety of patients

receiving opioids in the hospital setting by promoting

the use of Opioid Patient Risk Assessment Tool.

Nancy Cole is a Staff Nurse at Ute Mountain Ute

Health Center in Towaco, Colorado. She is nominated

for advocating for betterment of maternal and child

health of the Ute Mountain Ute Tribal Community

through clinical care, education, and public health out

reach and community collaboration.

Michelle Deuto is a Recovery Nurse Advocate at

West Pines Behavioral Health and Lutheran Medical

Center. She is nominated for advocating for pregnant

and newly delivered addicted women through creation

of a support program.

Maggie Devlin is a Registered Nurse at UC Health

in Fort Collins. She is nominated for advocacy of older

adults and people with serious and chronic illness

through education and utilization of advanced directives.

Nicole Downs is a Clinical Nurse in Labor and

Delivery at Penrose St. Francis Health Services in

Colorado Springs. She is nominated for innovation in

designing and implementing a practice change to reduce

postpartum hemorrhage in new mothers.

Natalie Fiore is Sexual Assault Nurse Examiner

Coordinator at The Medical Center of Aurora. She

is nominated for leadership in establishing and

expanding a program to provide a safe environment for

examination of sexual assault victims as well as providing

experience and expertise to have these cases successfully


Christine Gray is a Case Manager at Parkview

Medical Center in Pueblo. She is nominated for

innovation in creation of Policies and Procedures and

a Performance Based Evaluation Tool for Stoma Site

marking and for the creation of an Ostomy Support


Michele Hayo is a Registered Nurse at Mercy

Medical Center in Durango nominated for leadership

in addressing the issue of Emergency Nurse Lost

Compassion resulting in the provision of more holistic


Karen Kaley is Specialty Shift Coordinator at St.

Joseph’s Hospital in Denver. She is nominated for

advocating for newborns to reduce the need for

unnecessary antibiotics and increase the time new

mothers spend with their babies.

Kimberly Kassab is a Charge Nurse at Porter

Adventist Hospital in Denver. She is nominated for

leadership in implementing a process for nursing

assessment of the aggressive patient and establishing

a team for consultation and intervention in the

management of these patients.

David Lammers is a Clinical Resource Specialist

in the Emergency Department at St. Mary’s

Hospital in Grand Junction. He is nominated for

leadership in partnering with the cardiac group to ensure

that ST Elevation Myocardial Infarction metrics were met.

Carmencita Lorenzo Lewis is an ICU Registered

Nurse at Porter Adventist Hospital. She is nominated for

innovation in creating a nurse driven evidence-based

program to mitigate alarm fatigue in the critical care


Kristen Lynch is a Certified Nurse Midwife at East

Morgan County Hospital in Brush, Colorado. She is

nominated for innovation in implementing a “Spa Pap”

to promote relaxation for women having Pap Smears,

which increased the number of patients coming in for

preventative care.

Jodi Olson is Structural Heart and Valve Disease

Program Coordinator at the Cardiovascular Institute of

North Colorado/Banner Medical Group Western Region.

She is nominated for leadership in creation of the

Valve Clinic and the Structural Heart and Valve Disease

Program that increased the options for care for patients

in need of advanced catheter based therapy in Northern


Kim Powell is a Family Nurse Practitioner in the HIV

Primary Care Clinic at Denver Health. She is nominated

for advocating for transgender individuals by developing

a training curriculum to improve transgender care and

initiating a transgender primary care clinic.

Vivian Rodriguez is a Registered Nurse in Obstetrics

at SLV Health in Alamosa. She is nominated for being an

advocate for expectant parents by teaching childbirth

education classes as a volunteer community service

in order to reduce anxiety and improve the birthing


Ginenne Sullivan is an Education Coordinator

at Children’s Hospital. She is nominated for her

innovation in using technology to teach utilization of

nasal midazolam for seizure prevention to health care

professionals in rural areas.

Kelly Tuohy is a Charge Nurse at University of

Colorado Hospital in Aurora. She is nominated for

innovation in implementing acute stress disorder and

post-traumatic stress disorder screening for Burn Center

patients, allowing for early identification and treatment.

Deborah U-Ren is a Registered Nurse in the

Neonatal Intensive Care Unit at St. Mary’s Hospital and

Medical Center in Grand Junction. She is nominated for

advocating for minimizing antibiotic use in newborns

with the goal of reducing unnecessary NICU admissions

and reducing the separation of infants and mothers.

Kate Volle is a Critical Care RN at Penrose St. Francis

Health Services in Colorado Springs. She is nominated

for her leadership in creating an evidence-based

program to improve clinical outcomes for intensive care

patients by increasing patient mobility.

Shelly Weber is a Staff Nurse at St. Joseph Hospital

in Denver. She is nominated for innovation in reducing

Central Line Blood Stream Infections through creation

of an improved central line dressing kit and instructional

video and by ensuring competency certification for

bedside nurses.

Stephanie Wong is a Clinical RN Level III at UC

Health in Aurora. She is nominated for her leadership

in unifying seven policies related to epidural use into a

single policy, thereby decreasing variability in practice

and improving compliance with evidence based


Nadia Yanez is a Nurse Manager at Valley Wide

Health Systems in Alamosa. She is nominated for

leadership in improving tobacco cessation rates among

the patients at Cesar Chavez Family Medical Center. This

intervention will help reduce morbidity and mortality

related to COPD, Cardiovascular Disease and Lung Cancer.

These nurses represent the best of the over 80,000

nurses in Colorado. They demonstrate commitment to

actions and outcomes in caring for their patients, their

profession and their community. Twelve of these nurses

will receive Nightingale Awards. Read about the twelve

Nightingale Recipients and their accomplishments in the

August issue of Colorado Nurse.

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Health issues

affect us all...

Some issues can affect the ability to

practice safely.

Safe, caring, and confidential

services are offered to nurses and

nursing students.

If you, or someone you know experiences problems

caused by alcohol or other substance use, mental health,

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10 • Colorado Nurse | May 2018

Legislative Connection Dinner 2018

The Official Publication of the Colorado Nurses Foundation in partnership with the Colorado Nurses Association

Rebecca Sposato MS, RN

DNA 16 Member

Bipartisan cooperation was a common theme at

the 18th Annual Legislative Connection Dinner held

January 30th at the Scottish Rite Masonic Center. Every

year the event brings together the State’s lawmakers

and nurses from multiple specialties, student nurses

to discuss the health issues affecting the people of

Colorado. The evening had the highest attendance

ever with 56 nurses, 96 students and 18 legislators

for a total of 170 guests. The event was organized

by DNA #16 with C.J. Cullinan serving as mistress

of ceremonies, with DNA 23, SIG 23, SIG 30, SIG 31,

Colorado Center of Nursing Excellence, Colorado

Association of Nurse Anesthetist, Front Range of

Association of Neonatal Nurses as sponsors.

Bipartisan cooperation was already evident in the

remarkable accomplishment of the near unanimous

passing SB18-027: Enhanced Nurse Licensure Compact

within eight days of its first reading at the opening

of 71st General Assembly. Sponsoring Senator Jim

Smallwood describes it as a win-win for nurses and

patients by improving the application for multistate

nurse licensure candidates. Gil Romero, from Capitol

Success Group and lobbyist for CNA, introduced each

legislator and inquired about upcoming sponsored

bills. Several lawmakers shared the goals of transparent

billing and increasing the number of healthcare

professionals in rural counties. Senator Irene Aguilar

wants to establish channels for nurses to report unsafe

patient care situations. Many legislators expressed

respect for nurses’ dedication and essential role in

Colorado’s future.

Next several nurse leaders informed the audience

about upcoming legislative bills supported by CNA.

Patricia Abbott and Angela Petkoff who chair the

Government Affairs and Public Policy (GAPP) committee

are closely following HB18-1086: Community College

Bachelor Science Degree in Nursing and HB18-1114:

Licensure of Genetic Counseling and several bills

addressing opioid addiction and treatment.

Another benefit of the legislative dinner is

connecting with student nurses and giving

them an early start in advocating for the

profession. For many students, the Legislative

Dinner is their first encounter with CNA.

Lysa Mikes from Front Range Community

College responded that she was “excited

to bring change to the healthcare industry

and make safer working environments for

nurses who endure injuries and assaults.”

District 16 thanks everyone who made

the event a success, and is grateful to the

staff of Scottish Rite Masonic Center,

and also to First Baptist Church for

extending use of their parking lot. And

also thank all the following legislators

for their attendance.

Senator Irene Aguilar: District 32

Senator Larry Crowder: District 35

Senator John Kefalas: District 14

Senator Tim Neville: District 16

Senator Smallwood: District 4

Senator Jack Tate: District 27

Senator Nancy Todd: District 28

Senator Rachel Zenzinger: District 19

Representative Susan Beckman: District 38

Representative Jeff Bridges: District 3

Representative Janet Buckner: District 40

Representative Daneya Esgar: District 46

Representative Tracy Kraft-Tharp: District 29

Representative Susan Lontine: District 1

Representative Barbara McLachlan: District 59

Representative Paul Rosenthal: District 9

Representative Cole Wist: District 37

Senator Aguilar &

Student Attendee

Representative Todd, Mr. Todd

& CNA Member CJ Cullinan


Colleen C


Petkoff & Patr


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The Official Publication of the Colorado Nurses Foundation in partnership with the Colorado Nurses Association May 2018 | Colorado Nurse • 11

Buckner &


Representative Smallwood

& CNA Member Karren




Representative Lee



Representative Esgar

irs Angela

icia Abbott

Representative Bridges & CNA

Member Carol Goldstein

Representative Wist &

CNA Member Judith Burke

Representative Zenzinger &

Kathy Crisler

SIG 30 Members


Continuing Education Opportunities

• Bone Marrow Transplant Certified Nurse (BMTCN®) Review Class

(Metro Denver)-May 22nd – 23rd

• Stroke Symposium (Northern Colorado)- May 23rd – May 24th

• Trauma Nurse Core Curriculum-1 Day Provider Renewal

(Metro Denver)- June 1st

• Quality in Cancer Care (Northern Colorado)- June 16th

• Advanced Burn Life Support© (Metro Denver)- June 19th

• Trauma Nurse Core Curriculum (Metro Denver)- July 19th – 20th

• ELNEC (Northern Colorado)- September 12th – 13th

• Advanced Practice: Leading Healthcare into the Future

(Metro Denver)- September 28th

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12 • Colorado Nurse | May 2018

The Official Publication of the Colorado Nurses Foundation in partnership with the Colorado Nurses Association

Care Without Assumption:

A Conceptual Framework for Transgender Nursing Care

Denise S. Morris, Ed.D, MSN, RN

Patsy Starke, BSN, RN, CHPN

Reprinted from DNA Reporter

February, March, April 2018 Issue

Denise received her Doctorate

in Education from Wilmington

University, her Masters in Nursing

from Wesley College, and her

primary nursing diploma from

Beebe School of Nursing. She

is currently teaching graduate

nursing courses at Wesley

College. A strong advocate for

inquiry based education and

active participatory learning, Denise involves students

in research and evidence based practice in a variety

of community and small group settings focused upon

health promotion and wellness. Her professional interest

focuses on vulnerable population health, the spirituality

of caring in nursing, complementary and alternative

healing, and promoting a culture of curiosity in nursing

education. Dr. Morris has pending publications in

the Journal of Holistic Nursing and The Clinical Nurse

Specialist. In addition, she serves as a member of

the Graduate Committee for Wesley College, and is

a member of the American Nurses Association, the

Delaware Nurses Association, the World Professional

Association for Transgender Health (WPATH), the

National Association for Clinical Nurse Specialists, and

the American Holistic Nurses Association. Denise was

recently honored with Excellence in Teaching Award

for her contributions to nursing and health professions

education. Denise can be reached at denise.morris@

Patsy was born in 1959 as

William Patrick Starke. She is a

1996 graduate from the University

of Delaware with a Baccalaureate

of Science in Nursing and a minor

degree in Biological Sciences.

Patsy’s focus in nursing has always

been in the field of Community

Health where she began her

career providing migrant health

care for Delaware’s migrant population. She worked

in the area of health promotion for Delaware Division

of Public Health, and was instrumental in forging

a partnership with the March of Dimes Folic Acid

Coalition to develop strategies to promote folic acid,

as a necessary vitamin in pre-conception health to aid

in preventing neural tube defects in the early stages of

fetal development. Along with the Folic Acid Coalition,

a mascot named Folic Acid Man was created and Patsy

became Folic Acid Man to attend community functions;

thus, reaching Delawareans to promote the benefits of

Folic Acid. Patsy received the Dr. Katherine Esterly Award

for lifetime contribution to Perinatal Development in

Delaware from the March of Dimes. Patsy has worked

in the field of Hospice for the last 15 years, and is a

Certified Hospice and Palliative Care Nurse (CHPN). Patsy

began her Transition to her true self, as a Transgender

Woman, in April of 2016, and she refers to that as her

second birthday after a lifetime of struggles with her

gender identity. Patsy now dedicates her life and nursing

career to: End of Life Care, LGBT healthcare, mainly

Transgender Health Care, and advocacy for LGBT equality

issues. She is a proud member of WPATH, GLMA, SAGE,

and HPNA. She is a prolific writer in poetry and short

stories on where she publishes her works.

Transgender individuals have been a part of world

cultures historically, yet the support for the healthcare

of such populations has only received attention in

recent decades. The World Professional Association

for Transgender Health (WPATH) published Standards

of Care (7th edition) in 2012, which focused on the

medical and psychological approaches that foster the

highest quality of care for this vulnerable population

(Coleman, et al, 2012). While these standards support

an understanding of surgical, hormonal, cosmetic, and

psychological care, it does not identify nursing care and

nursing related etiologies for transgenderism.

Further, an extensive review of the literature offers

few evidence based articles related to nursing care

or nursing implication for transgender individuals.

According to Berreth (2003), the dearth of literature

regarding nursing care for the transgender person

puts this population at risk for a plethora of problems

associated with uniformed nursing care. For nursing to

properly address the needs of this special population, it

is incumbent upon nurses to conduct patient-centered

research that is based upon the life experiences of the

transgender that is grounded in a conceptual framework

specific for nursing care and nursing education.

Negative Outcomes

As holistic practitioners, nurses are positioned to

explore these life experiences and to create a conceptual

framework (McCabe, 1988). The absence of a framework

to guide nursing in the provision of care that is without

assumption can easily lead to unintended prejudices and

discriminatory behaviors (McDowell, 2016). Examples

of such unintended consequences are referring to the

patient by non-preferred pronouns, room assignment

by gender, gender insensitive assessment tools, HIPPA

violations, assessment of high risk behaviors and

potential negative outcomes such as suicide. A lack of

curricular preparation in gender-affirming care creates

additional barriers resulting in health inequities and

adverse outcomes. According to Reisner et al. (2015), a

community sample of transgender patients indicated

a 24% incidence of discrimination which resulted in

the postponement or delay in needed care. In addition,

these patients screened positive for depression and other

negative psychosocial symptoms. Grant et al. (2011)

indicated key barriers to seeking healthcare included

stigmatization, discrimination and fear of being refused

care because of their gender status, and even verbal

harassment and physical attack.

Lack of Knowledge

One key functional barrier to transgender care is

the lack of provider knowledge without assumption.

The current nursing curricula inadequately defines

and addresses appropriate transgender care and

may contribute to false thinking that may lead to

heterosexism and homophobia (Zuzelo, 2014). In

addition, the Transgender patient is forced to educate

the nurse on the limited knowledge currently available

for his or her care. Transgender people are already

marginalized, feeling oppressed, grappling with social

and healthcare disparities, and in need of medical

attention, and now they must stop and educate the

person they expect to help them (Biederman, 2016). This

lack of knowledge will clearly affect the confidence level

of the patient and prevent seeking care or withholding

key information that supports informed decision making.

Nurses can do better. Nurses want to know.

A Guiding Framework

Using a combination of the critical (Weaver and Olsen,

2006) and interactional paradigms (Gillis & Jackson,

2002) we created a model entitled “Care without

Assumption” (see Figure 1). This model is grounded

in key assumptions that nursing practice must move

toward the elimination of social struggle and oppression

in society, while fostering the examination of the

phenomena through the eyes of the people experiencing

it. The model aims to shift the paradigm for nursing

to that of a gender transcendent world view. Nursing

ontology is innately caring, therefore, to be a nurse, one

is called to develop the full potential of caring expressed

ethically and without bias. Like many nursing models the

components include the nurses affect upon the patient

domain, the systems domain, and the domain of nursing

practice. It includes, however, suggested drivers that

support inclusive gender neutral educational preparation,

Join our team of 30 RNs along with

Drs. William Schoolcraft, Eric Surrey,

Robert Gustofson, Laxmi Kondapalli,

Sara Barton and Lauren Ross Ehrhart

who provide care for more than 2,000

infertility patients each year.

Please send resume to Diane

Tindall at

The Official Publication of the Colorado Nurses Foundation in partnership with the Colorado Nurses Association May 2018 | Colorado Nurse • 13



relationship building, self-assessment, process

management, and a culture of ongoing research that

will establish evidence based protocols and dispel the

myth associated with transition. By using the framework,

the nurse can move the domains and drivers along a

continuum from Assumption to Non-assumption.

The use of such a framework will provide the

foundational position for nursing practice and nursing

education that might mitigate discriminatory actions

and foster normalization of sexual diversity. Additionally,

the Care without Assumption framework offers support

for the creation of core competencies for transgender

care, gender sensitive assessment tools, and a protocol

of universal standards of interaction for nursing (Starke,

personal communication, 2016). Nurses who use the

Figure 1. Care without

Assumption Model. Nursing

model conceptualizing a gender

transcendent nursing world view.

Source: D. Morris & P. Starke

(2017) copyright pending.

Used with permission.

framework will foster a culture of curiosity for research

regarding inclusivity and embrace a world view of gender

transcendence in nursing care. As with all models,

additional research and testing is necessary.


Berreth, M.E. (2003). Nursing Care of transgendered

older adults: Implications from the literature. Journal

of Gerontological Nursing: (July 2003) 44-9. Retrieved




Biederman, D. & Hines, D. (2016). Barriers to care for

transgender people: A conversation with Dana Hines,

PhD, MSN, RN. Creative Nursing; 22(2), 128-134. Springer

Publications. doi: 10.1891/1078-4535.22.2.128

Coleman, E., Bocktin, M., Botzer, P, Cohen-Kettenis, P.,

DeCuypere, G., Feldman,J., ….Zucker, K. (2012). Standards

of care for the health of transsexual, transgender, and

gender-nonconforming people, 7th ed. International Journal

of Transgenderism, 13.

Gillis, A., & Jackson, W. (2002). Research for nurses: Methods

and interpretation. Philadelphia, PA: F. A. Davis Company

Grant, J.M., Mottet, L.A., Tanis, T., Harrison, J., Herman, J.L.,

& Keisling, M. (2011). Injustice at every turn: A report of

the National Transgender Discrimination Survey. Retrieved



McCabe, S.V., (1988). Male-to-female transexualism: A case for

holistic nursing. Archives of Psychiatric Nursing 2(1), 48-53.

Retrieved from




Reisner, S. L., Hughto, J. M., Dunham E. E., Helflin, K. J.,

Begenyi, J. B., Coffey-Esuivel, J., & Cahill, S. (2015).

Legal protections in public accommodations settings: A

critical public health issue for transgender and gendernonconforming

people. The Milbank Quarterly, 93, 484-

515. doi: 10.1111/1468-0009.12127

Weaver, K. & Olson, J. K. (2006). Understanding paradigms

used for nursing research. Journal of Advanced Nursing,

53(4), 459-469. doi: 10.1111/j.1365-2648.2006.03740.x

Zuzelo, P., (2014) Improving nursing care for lesbians, bisexual,

and transgender women. Journal of Obstetrics, Gynecology

and Neonatal Nursing, 43(4): 520-530. doi:10.1111/1552-


Expand your clinical teaching skill set! The Center’s next

Clinical Scholar training classes will be July 16-20, 2018. This

popular workshop will increase your clinical teaching skills

and help educate the next generation of Colorado nurses.

Growing Diverse Nurses Through Mentoring. Join our

Mentor Training Institute on August 17-18, 2018 to help increase

nursing diversity. We will provide you with the tools needed to

become an effective mentor for diverse nursing students.

See, contact us at or (303)715-0343 x17

Awards Committee Seeks


The CNA Awards Committee is seeking nominations for the 2018 CNA Awards

which will be presented at the 2018 CNA Membership Assembly on September 15,

2018. Awards will be presented in the following categories:

• Margie Ball Cook Award for a CNA member who has advanced equal

opportunities in nursing for members of minority groups.

• Sara Jarrett Award for a CNA member who has contributed to nursing practice

and health policy through political and legislative activity.

• CNA Leadership Award for a CNA member who has served as a leader in CNA

through service on the Board of Directors or on a committee or task force.

• CNA Emerging Leader Award for a CNA member who has been a nurse for no

more than ten years and who is emerging as a leader in CNA or a DNA.

• Carol O’Meara Award for a CNA member who has made sustained

contributions to CNA.

Nominations will also be accepted for the CNA Hall of Fame. The CNA Hall of

Fame was established in 2004 to honor CNA Members whose dedication and

achievements have significantly affected the Colorado nursing profession. Nominees

for the Hall of Fame may be living or deceased. Criteria for the Hall of Fame are:

1. The nominee must have demonstrated leadership that affected the health and/

or social history of Colorado through sustained, lifelong contributions in or to

nursing practice, education, administration, research, economics or literature.

2. The achievements of the nominee must have enduring value to nursing

beyond the nominee’s lifetime.

3. The nominee must have been prepared in a formal nursing program.

4. The nominee must have worked in or represented Colorado.

5. The nominee must be or have been a CNA member.

To nominate an individual for any of these awards, send a statement to the CNA

Awards Committee which describes why your nominee should receive the award.

Include the name of your nominee as well as your name and contact information.

Please limit your statement to two double-spaced pages. Email your statement to Deadline for receipt of nominations is August 1, 2018.

The Awards Committee may seek additional information regarding the nomination.

In addition to these state level awards, each DNA is invited to designate a DNA

Nurse of the Year. Selection of the DNA Nurse of the Year is determined by the

DNA. DNA Nurses of the Year will be honored at the Awards Presentation at the

CNA Membership Assembly. DNA’s should submit the name of their DNA

Nurse of the Year, along with a statement about why the nurse was

selected to the Awards Committee by August 15, 2018. Email information to

Contact Carol O’Meara, Awards Committee Chair, at 303 779 4963 or with any questions regarding CNA Awards.

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14 • Colorado Nurse | May 2018

The Official Publication of the Colorado Nurses Foundation in partnership with the Colorado Nurses Association

Introducing the Colorado Nurses Association 2017-2018

Board of Directors Part II

Board of Director Members:

Mary Ciambelli, PhD, RXN, PMHCNS-BC

Kathy Shaw, DNP, RN

In the February 2018 Colorado Nurse, you were

introduced to half of the Board of Directors. As

promised, this article introduces the other half of our

current Board. In the interim, Dr. Terry Schumaker

DNP, RN has resigned her position from the Board of

Directors. The Colorado Nurses Association (CNA)

and the Board of Directors thanks her for her years of

service to DNA 7 and to the Board. In September 2018

we will be electing a President Elect, Vice President,

Treasurer, three Regional Directors and an At Large

Director. For more information about the roles and

responsibilities of the officers and Board members,

please consult the CNA. By-laws on our website www.

Region II Representative: Lori Rae Hamilton, RN,

MSN lives and works in Region II which encompasses

Colorado Springs, Pueblo and a large portion of the

south eastern and southern portion of Colorado.

Ms. Hamilton is the Dean of Instruction for Trinidad

State Junior College in Trinidad, Colorado which has

both LPN to ADN programs and an associate degree

program. She also serves as an advisor for the Colorado

Student Nurses Association for the past several years.

Lori Rae is a member and Past-President of DNA 4.

Ms. Hamilton is focused on engaging undergraduate

nursing students in both associate and baccalaureate

programs in their student association and championing

new graduate nurses as they transition to practice.

Region II Representative: Hilary St. John, RN,

MSN, BSN lives in Region II and has worked in a variety

of emergency, surgical, oncology, plus medical and

surgical areas during her 13-year nursing career. Most

recently Hilary has been an Assistant Nurse Manager at

two different hospitals. Hilary was born in England, has

worked as a flight attendant and traveled extensively.

Ms. St. John has also lived in many different countries

including the Middle East. Her great passion is leading

and inspiring others to improve healthcare delivery

and to be responsive to our ever-changing healthcare

industry with a special interest in diversity.

Region III Representative: Mary Ciambelli,

PhD, RXN, PMHCNS-BC lives in Silverthorne CO. She

is employed by Mind Springs Health, a non-profit

community mental health center serving the Western

Slope. As a psychiatric mental health clinical nurse

specialist with prescriptive authority she is a longterm

member of Special Interest Group (SIG) 31. Dr.

Ciambelli has served in a variety of roles in local and

state-wide nursing and health care groups. Her current

focus is to engage nursing students, registered nurses,

graduate students and advanced practice nurses in

Region III to develop a thoughtful, unified, evidence

based voice during the upcoming Sunset of the Nurse

Practice Act.

Region III Representative: position is vacant for

2nd representative.

At Large Representative: Jody DeStigter, MS,

RN-BC is employed as the Professional Development

Specialist at University of Colorado Health Longs

Peak Hospital. She is in the second year of the first

term of this position. Ms. DeStiger is an educator

at heart and actively participates in a variety of

learning opportunities and wants to support others

in professional development. Her goal is to share the

benefits of the Association, advocate for registered

nurses and engage registered nurses in their own

professional development. Ms. DeStigter sees the

nursing profession as a quilt, many different colorful

pieces and different shapes, and when we all work

together we are a beautiful piece of art. DeStigter

also serves on the CNA Continuing Nursing Education

Advisory Council, formerly known as the Approval


At Large Representative: Ingrid Johnson, DNP,

MPP, RN works as a project director at the Colorado

Center for Nursing Excellence and is in her first term as

an At Large Director. Dr. Johnson was inspired to run

for the BOD because of her contact with nurses who

work in rural and underserved areas and observing the

impact of advocacy on our profession. She believes

that our profession must welcome all registered

nurses to join the Association to ensure that Colorado

has a vibrant nursing workforce for years to come.

Dr. Johnson’s hope is to build a stronger and more

empowered membership base across Colorado.

At Large Recent Graduate: Adam Diesi, RN, BSN is

serving in his second term in this position. He is a Past-

President of the Colorado Student Nurses Association

where he enjoyed working with, and advocating for,

the student nurses of Colorado. He is employed as

a Cardiac Intensive Care Unit nurse with a passion to

help and to provide a voice for up and coming nurses

so that they may be successful in the nascent stages of

their careers.

Thank you to all members of the Colorado Nurses

Association Board of Directors. It is the work of the

Board of Directors to shape the future and prioritize

membership voices.

Friends of Nursing Fundraiser and Celebration

Members of Friends of Nursing (FON)

and their friends and families celebrated

the season December 1st at a Holiday

Event at The Lakewood Country Club.

There were 85 in attendance and

everyone had a great time while raising

funds for nursing scholarships.

The highlight of the evening was a

performance by the Skyline Chorus. If

you have not seen their performance it

is a must see. They do an outstanding


Visiting with them were LaFawn

Biddle, life member of FON; Dr. Amy

Barton (President FON) and Dr. David

Barton, Dr. Cris Finn (Past President

FON) and husband Ken and family, and

photographers Jim Medford and Gerry Case.

FON Co-founder Greta Pollard and husband Donald

enjoyed the festive evening with long-time members

Silent auction and


Phyllis and Rod Wicklund; Dr. Juanita

and Tom Tate; Donna and Dr. Karl

Bernklau; Dr. Marilyn Krajicek, Dr. Amy

Barton and Dr. David Barton; Andy and

Judy Robinson, Dr. Sara and Howard

Jarrett; Dr. Cris Finn and husband Ken

and family; Dr. Ann Smith; and Dr. Ruth

O’Brien to name a few.

The silent auction exceeded

expectations. Thank you to those who

bid on our wonderful baskets and

vacation get away. If you have items for

the silent auction for the Scholarship

Luncheon please contact Cris Finn


The purpose of Friends of Nursing

is to advance professional nursing

by providing scholarships for quality education in

baccalaureate and higher degree programs in Colorado

Schools of Nursing. In 2017 just under $60,000 was

awarded to 21 scholars.

Deck the Halls members at tables

Friends of Nursing welcomes all who are interested

in its activities. The organization is governed by elected

officers and a board of directors. Its funding comes

from membership fundraising efforts. With no office,

no paid staff, no overhead, minimal expenses and

100 percent volunteer effort, all monies go totally to

support the purpose.

SBIRT Training Available Online at No Cost

Earn CNE credits!

Screening, brief intervention and referral to

treatment (SBIRT) training is now available

online. Learn to screen patients for alcohol

and drug use and practice motivational


Training Includes:

– SBIRT overview

– Interactive simulations to practice

motivational interviewing skills with

adolescents and/or adults

To access online training visit: • 303.369.0039 x245

See Peer Assistance Column on Page 5




The Official Publication of the Colorado Nurses Foundation in partnership with the Colorado Nurses Association May 2018 | Colorado Nurse • 15

Faith Community Nursing in


Elaine Taylor, RN

Every day Faith Community Nurses in Colorado are making a difference in our

communities. We are more than 300 RNs embedded in familiar community places

mobilizing resources so that everyone has access to health care. We are working

hard to close the gap in health disparities and inequalities. We advocate for

wholistic health care.

You may see us volunteering at the free clinic promoting access to healthcare

or encouraging wellness at the health fair. You may see us promoting a walking

ministry at the church or serving soup to the homeless. We are the ones with

flu shots and aspirin. Because health care is critical to the well-being of our

communities, we believe that the work we do as Faith Community Nurses will create

change, not only in individual lives but also in our communities.

It has been twenty years since the University of Colorado School of Nursing

taught the first course of Faith Community Nursing. Now the Foundations in Faith

Community Nursing Courses are available state-wide online. These courses are

designed to prepare actively licensed registered nurses with the skills necessary for

this specialty practice.

In Colorado we have a state-wide organization encouraging us in our endeavors:

Faith Community Nursing in the Rockies supports all Faith Community Nurses

through its website, workshops, networks, and scholarships. (

Our organization is supported by membership dues and donations. Its purpose is to

advance faith community nursing as a specialty in Colorado. We support research

and provide continuing education programs. Over the past 20 years, our experience

has shown us that the work being done by Faith Community Nurses has made a

positive impact in our community. As an example, Elaine Taylor, MHA, BSN, RN, FCN

is one of the many faith community nurses in Colorado. She had the privilege of

opening a free clinic. It started with a conversation that generated action. It became

a reality due to her persistent effort and unwavering dedication of the church.

Who would’ve thought in 2018 there would still be a need for a free clinic. Despite

the Affordable Care Act, about 350,000 Coloradoans still do not have health

insurance. The affordable part of the ACA is still elusive. The high cost of insurance

continues to be the number one reason for not having insurance. And 10% of

Coloradoans say they didn’t get needed doctor care because it was too expensive.


The Good Samaritan Clinic

opened its doors on January 6 and

is committed to connecting people

with quality health care, meaningful

volunteer opportunities and trusted

educational experiences.

“We are called as nurses to care

about the physical, emotional, and

spiritual well-being of others. If the

church is not a place for healing,

then where can we go?” says

Elaine Taylor.

Everyday in countless large

and small ways, Faith Community Nurses make our communities a better place.

These moments of advocacy change lives. For more information, contact Westberg

Institute for Faith Community Nursing. (

“The call to serve involves something special, to which we must be attentive…”

Pope Francis

Announcing Colorado Nurses

Association as an ANCC

Accredited Approver

Colleen Casper, DNP, RN, MS, Executive Director

The Colorado Nurses Association (CNA) is pleased to announce it

is now an Accredited Approver Organization for American Nurses

Credentialing Center (ANCC).

ANCC Accreditation is a voluntary, peer review process intended to

strengthen and sustain the quality and integrity of continuing nursing

education. Approvers demonstrate excellence in evaluating providers of

continuing nursing education (CNE) for quality and excellence in curriculum

design and delivery. Accredited approver organizations, like CNA are

credentialed to assess, monitor and assist CNE providers in adherence to

comprehensive, evidence-based ANCC criteria.

As an Accrediting organization, CNA will assess providers of continuing

nursing education and ensure they adhere to rigorous global standards set

forth by ANCC. Organizations approved by CNA will now be known for

providing the highest quality continuing nursing education.

We are proud to be acknowledged by ANCC for our commitment and

excellence in recognizing organizations that provide the highest quality

continuing education for nurses. Please see the Colorado Nurses Association

website for information/education on the steps

your organization can take to become an Approved Provider of continuing

nursing education or to provide individual educational activities. Please note

we are offering virtual “Conversations with the Nurse Peer Review Leader”

on April 3 & May 23, 2018. Please watch our calendar and website for more

information to be able to call or video chat with our Nurse Peer Review Leader,

Connie Pardee, PhD, RN, who will answer your questions regarding approved

continuing nursing education at your organization.

Colorado Nurses Association Continuing Nursing Education Advisory

Council looks forward to working with you and/or your team to support ANCC

accredited continuing nursing education. We can support Individual Activities

you may like to sponsor, as well as Accredited Provider status to provide a

variety of multiple individual or ongoing continuing nursing education activities.

Please contact Colorado Nurses Association for more information or go to our

website and click Education for more information.

Relocation bonuses available | Excellent benefits

IHS or NHSC loan repayment program eligible

CONTACT: Michelle Beasley, BSN, RN

Director of Nursing Recruitment


Phone: 928-729-8394

16 • Colorado Nurse | May 2018

The Official Publication of the Colorado Nurses Foundation in partnership with the Colorado Nurses Association

District & Special Interest Group Reports


Anne Zobec, RN, MS, AOCNP

Board Member

Kate Peterson provided our spring program on

March 12 about her Quality Improvement (QI) project

“Implementing an early mobility program in the ICU.”

She discussed how her involvement with CSNA and

CNA gave her the skills to thrive in her nursing career.

She has been very successful in implementing QI

projects. Kate also presented this information at the

ANCC Magnet conference in Houston!

We were delighted to promote this program to

nursing students.

We are making plans for a Nursing Week

Celebration at a local restaurant in May.


Sandie Nadelson, RN, PhD

The CNA District 5 held a

March meeting to discuss goals

for the coming year and how

to enhance Western Colorado

nurses’ involvement. Those in

attendance felt that we need

to have a strong focus in order

to promote participation. We

decided that focusing on palliative care and improving

the quality and number of serious illness conversations

between health care providers and the community

is an important need we should help meet. During

the meeting, we searched the American Nurses

State of Wyoming, Department of Health, Aging Division,

Healthcare Licensing and Surveys is recruiting for

Health Facility Surveyor

Recruitment ID: HSHP09-07627 & HSHP09-07975

You will serve as a Health Facility Surveyor within the Health Care

Surveillance Branch, State Office of Healthcare Licensing and Surveys,

Wyoming Department of Health, conducting surveys and investigating

complaints statewide in accordance with Wyoming State Statutes and

agreement with the federal Centers for Medicare and

Medicaid Services (CMS).

For more information or to apply online go to:

and search HSHP09.

Open until filled. EEO/ADA Employer.

Associations’ website and found that ANA and the

Hospice & Palliative Nurses Association (HPNA) have

worked together and developed a call to action related

to palliative care. The action plan has twelve key

recommendations (see American Nurse Today: May

2017, Volume 12, No. 5). The list of action items is quite


We are not ready to act on them all, but felt that we

would start by promoting the conversations through

increasing awareness of models, education on how

these conversations happen, and supporting both

practitioners and patients in moving to open and clear

communication about serious illness conversations. We

invite you to join us in the conversation.


Charlotte Ledonne, RN, BSN, MA, LPC

President DNA

The District 6 Colorado Nurses Association and the

SLV AHEC hosted the 14th SLV Nightingale Event on

February 16th at Adams State University. Reina Chacon,

Monica Hinds, Zina Horton, Laura Lewis, Misty Palacios,

Patricia Robertson, Vivian Rodriguez, Leroy Romero, T.J.

Salazar, Lou Ann Cheslock Skinner and Nadia Yanez

were recognized for their commitment to their patients

and providing excellent nursing care. Vivian Rodriguez,

SLV Health, Lou Ann Cheslock Skinner, Valley Wide

Health Systems and Nadia Yanez, Valley Wide Health

Systems, were selected as luminaries for the statewide

event in Denver on May 12, 2018.

Angie Medina, faculty at

Trinidad State Junior College,

Valley Campus, was nominated

by President Dr. Simone to

receive the inaugural Dale P.

Parnell Distinguished Faculty

recognition by the American

Association of Community

Colleges (AACC). She will be

highlighted for the difference she

is making in the lives of students

at the 2018 Annual Convention

to be held in Dallas, Texas from

Angie Medina,

DNA 6 Member

April 28 – May 1, 2018. Nominees for the faculty

distinction recognition should: Demonstrate passion for

the students and the classroom, show willingness to

support students, inside and outside of the classroom,

be inclined to participate in college committees, and

go above and beyond what is required to ensure that

students are successful in their academic endeavors.

Dr. Simone stated “Your work with our students is

first class and, from my experience, you have always

been willing to pitch in as a valuable team member.

You are very deserving of this recognition.” Join us in

celebrating this honor for Angie!

It is with great sadness that DNA 6 reports the loss

of Louise Sowards, RN, BSN, MSN. Louise was an active

member of DNA 6 and her community in the San

Luis Valley. Louise loved nursing in various roles and

facilities in the San Luis Valley throughout her nursing

career. She also loved teaching nursing at numerous

institutions over the years and directed the Trinidad

State Junior College nursing program from 2009-2012.

Louise inspired her daughter Jodi to become a nurse,

and Jodi now directs the TSJC Valley Campus nursing

program. Thank you Louise for the many patients,

students and nurses you have mentored and guided

over the years.

For information, call Charlotte Ledonne, nurse

coordinator with the San Luis Valley Area Health Education

Center at or 719-589-4977.

DNA 16

Christine Schmidt, President

Our major event of the year, the 18th Nurse

Legislator Connection Dinner, was a great success!

Measuring the great turnout, the very positive

comments in the evaluations received, and the great

positive energy resulting from the recent passage

of the enhanced nurse licensure compact bill due to

overwhelming support from nurses, we continue to be

proud to sponsor this annual event. We had a turnout

of 174 including 18 legislators and over 80 students.

Some comments from attendees included: Excellent –

best ever! – good – helpful information about how to

connect personally and meaningfully with legislators,”

and “All was great! – good – keep it going – so

gratifying to hear appreciation and recognitions from

legislators – 1st time attended – valuable!” CJ Cullinan

also received high praise for being, “warm, dynamic,”

and, “a wonderful presenter.” Much appreciation goes

to all our wonderful colleagues who helped set up,

host, and take down the event. And many thanks to

our generous co-sponsors, SIGs 30 and 31, DNAs 3 and

23, the Colorado Association of Nurse Anesthetists, the

Front Range Association of Neonatal Nurses, and the

Center for Nursing Excellence.

The Official Publication of the Colorado Nurses Foundation in partnership with the Colorado Nurses Association May 2018 | Colorado Nurse • 17

District & Special Interest Group Reports

Plans for spring events include speaker Maro

Casparian, Director of Consumer Protection from the

Denver District Attorney Office on scams/fraud/identify

theft and elder abuse, arranged by Nan Morgan to

be held April 17 at Kaiser Franklin building. Nan also

has us group registered to volunteer for Project Cure

Tuesday March 20, 6:00-9:00pm, everyone is welcome

to join us.

Don’t miss our annual Nurses Night at the Rockies,

coordinated annually by Mary Kershner, on Thursday

May 10 at 6:40pm, during National Nurses Week

for the Colorado Rockies vs Milwaukee Brewers.

New this year is that after Mary’s discussion with

Rockies marketing representative, the Rockies will

officially create “health care appreciation night,

“with a donation from every purchased ticket to go

to Colorado Nurses Foundation. We had 300 nurses

attend last year, the highest number since this event

began in 1997, and hope to top that this year.

DNA 16 meetings are held the 3rd Tuesday of the

month from 6-8pm with announcements posted

on CNA website along with e-mails to district 16

members. RSVP to

DNA 20

SIG 30

Janece Moore, MSN, RN, FNP-BC

Special Interest Group 30 (SIG 30), Colorado Society

of Advanced Practice Nurses group, recently awarded

scholarships to three students. Tu Nguyen, Meghan

Abrams and Josh Zucker are each the recipients of a

$500 scholarship.

In 2017, SIG 30 set out to improve the monthly

meetings by expanding the educational content and

meeting locations. In February, SIG 30 was successful in

Updates from the Department

of Regulatory Affairs

this endeavor by hosting the SIG 30 monthly meeting

in Arvada and covering pediatric content.

The SIG 30 meetings are held the first Wednesday

of the Month. The meeting announcements are

sent via the ENP network. Sign up for SIG 30

announcements at Join us at

the next meeting.

The American Association of Nurse Practitioners

(AANP) will be hosting their 2018 national conference

in Denver. The conference will be held downtown at

the Colorado Convention Center June 26 - July 1, 2018.

For more information visit the AANP website at www.

The Enhanced Nurse Licensure Compact

(eNLC) has Arrived in Colorado

Norma Tubman, RN, MScN

Kudos to Allison Windes, DNA 20 Fundraiser, who

sold 30 tickets to members, families, and friends to

attend the musical The Producers on April 8 at the

Lakewood Cultural Center. The $120 raised will go

towards funding our $1500 annual nursing scholarship.

At our March meeting, Ashley Stone RN, MSNc,

Independent Contractor/Consultant with StoneGale,

LLC did team building exercises with attendees. In

April, we were honored to have Representative Brittany

Pettersen (D) as our speaker. Representative Pettersen

spoke about HB-1003 Opioid Misuse Prevention which

she is sponsoring. The bill addresses measures to

prevent misuse of opioids in Colorado. The personal

story behind her interest in opioid misuse made her

presentation especially compelling.

Congratulations to Annette Cannon who, through

Platt College SON and Cannon Health Care Consulting

and Education, gave two presentations at the 11th

Annual Partners in Education and Integration of

IENs Conference held April 25-29, 2018 in Montreal,

Canada. Annette gave an oral presentation titled

“Integration in Employment” and a poster presentation

titled “Promoting Transition and Development

of Clinical Practice through Culturally Responsive


For information on DNA 20 meetings, contact

President, Annette Cannon at

or see the CNA website.






Nurse Call Intercom

CCTV Paging


Access Control

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Under the new compact, nurses may provide care to

patients in other eNLC states without having to obtain

additional licenses. There are currently 29 member states

in the expanded pool within the eNLC, including Florida,

Wyoming, Oklahoma, Georgia, and West Virginia -

which did not participate in the original compact.

Nurses holding a Colorado multi-state license

issued before July 21, 2017 have been automatically

placed into the new compact as part of a grandfather

provision with no further action needed.

But a new fingerprint-based criminal background

check requirement is a fresh reality for many nurses

in the state, including new applicants. The fingerprint

background check is one of 11 uniform requirements

within the eNLC, which Colorado joined with the

adoption of Senate Bill 18-027 earlier this year.

In addition to new applicants, Registered Nurses and

Licensed Practical Nurses who were issued a multi-state

license between July 21, 2017 and January 18, 2018 were

required to obtain fingerprint background checks and

have them reviewed by the State Board of Nursing before

April 19, 2018 in order to maintain multi-state licensure.

Nurses falling within the “gap” who missed the April

19 deadline, and still have not had their fingerprints

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reviewed by the State Board of Nursing, have been

reverted from a multi-state to single-state credential.

This group should immediately submit their fingerprints

to the Colorado Bureau of Investigation (https:/www. for subsequent Board

review. Once fingerprints are submitted and reviewed

by the Board, these licensees will be converted to

multistate status, if qualified.

For more information on the eNLC and updated

application requirements, visit https://www.colorado.


Volunteers of America is actively seeking additional

RNs, LPNs, & CNAs in all six of our locations. If you

desire to make a difference in someone’s life, come and

join our dedicated health care team. We offer competitive

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We look forward to hearing from you!

For more information, please contact Liza Lucero,

Executive/Human Resources Assistant at 970-209-6202.

18 • Colorado Nurse | May 2018

The Official Publication of the Colorado Nurses Foundation in partnership with the Colorado Nurses Association

American Nurses Association

When Nurses Speak, Washington Listens

The American Nurses Association strives to

represent nurses on Capitol Hill, provide support for

state nurses associations as they advance their own

advocacy agendas, and help federal agencies and

elected officials propose and enforce new laws that will

advance the nursing profession. ANA serves to amplify

nurses’ voices as policies are conceived, debated, and

implemented. We create long-lasting relationships with

nurses and their representatives, working to establish a

health system where care is accessible, of high quality,

and recognizes the nursing profession as an integral


Registered nurses represent the largest segment

of health professionals, with more than 3.6 million

nationwide. Nurses not only represent an incredible

force by sheer numbers, but policymakers rely upon

their expertise as they work to improve our nation’s

health system. For 16 years, nurses have outranked all

other professions in Gallup’s annual honesty and ethics

survey and are viewed as the most trusted profession.

Throughout the year, we will feature examples

of ANA members advocating for patients and the

profession in various roles and settings, hosted at as well as shared through social

media. The advocates’ stories will be paired with

associated tools and ANA products & services. Each

quarter will have a dedicated theme, building from

local to more global examples, but overlap with other

quarterly themes will occur.

Nurses are advocates every day, so examples are

endless and no illustration is too small. Please consider

sharing your story and being recognized by ANA and

your colleagues.

Send either a brief written description (under 150

words) OR a video (less than a minute) capturing your

experience: actions, any challenges / barriers as well

as strategies and any words of wisdom or tips for

colleagues. If providing in writing, please include a

high-resolution picture.

Questions or submissions should be directed to Janet

Haebler,, at ANA.



Each quarter will have a dedicated theme, building

from local to more global examples, but overlap will occur.

Q1: Nurses advocating locally (January – March)

Highlighting efforts at the bedside or in the

community both for individual and/or groups of patients

and/or nurses. Some examples: patient-focused practice

changes/process improvements; workplace safety policies

addressing issues such as staffing, workplace violence,

safe patient handling and mobility; and representing the

interests of patients, consumers and/or the profession

while serving on a committee, council or board.

Q2: Nurses influencing elected officials and other

key decision makers (April – June)

Highlighting efforts to impact change with key

decision makers that are local, state or federal. Could be

employer specific, immediate community/county, state

legislative/regulatory, or federal. Individual influence as

well as participation in a coalition.

Q3: Nurses get out the vote! (July- September)

With the approach of election day, emphasis

will shift to political examples. Highlighting nurses

leveraging their position as most trusted profession to

impact policy change and 2018 campaigns. Will feature

nurses who participated in a campaign, currently in or

running for an elected or appointed position, and/or

have a productive relationship with their elected official.

Q4: Global Impact and Making every year a year

of advocacy (October – December)

Continue highlighting nurses who have had an

impact within their community, state, or at the federal

level, while also expanding to experiences beyond

the US borders. Considering 2019 and future policy

issues relevant to the nursing profession, will include

an analysis of the November election results as well as

insight on potential impact of political advocacy, and

tips and words of wisdom on how to make every year a

year of advocacy at any level in any role and setting.

To learn more about ANA advocacy efforts and what

you can do to help, visit:


Just Because You Received This Publication, Doesn’t Mean You Are A CNA Member

The Official Publication of the Colorado Nurses Foundation in partnership with the Colorado Nurses Association May 2018 | Colorado Nurse • 19

Medical Marijuana

Information for providers

Note: This is primarily intended to inform

providers treating patients > age 18 years for whom a

recommendation for medical use of marijuana is being


“Cannabis” is used interchangeably with

“marijuana.” Cannabinoids refer to chemical

components of cannabis (i.e., THC or cannabidiol

[CBD], including synthetic versions).


• There is substantial evidence that cannabis or

cannabinoids are effective for:

ú Treatment of chronic pain in adults – primarily

neuropathic pain. 1,2

ú Treatment of chemotherapy-induced nausea

and vomiting. 1

ú Improving patient-reported multiple sclerosis

(MS) spasticity symptoms. 1,2

• There is moderate evidence that cannabis or

cannabinoids are effective for:

ú Treatment of short-term sleep outcomes

(associated with obstructive sleep apnea,

fibromyalgia, chronic pain, MS). 1

ú Treatment of drug resistant seizures with

CBD in children and young adults with Dravet

syndrome. 3

• There is limited evidence that cannabis or

cannabinoids are effective for: 1

ú Increasing appetite/decreasing weight loss

associated with HIV/AIDS.

ú Improving provider-measured MS spasticity


ú Improving Tourette syndrome symptoms.

ú Improving anxiety symptoms (in context of

assessment of social anxiety symptoms).

ú Improving post-traumatic stress disorder

(PTSD) symptoms.

• There is no or insufficient evidence that

cannabis or cannabinoids are effective for all

other diseases and conditions, due to lack of

published clinical trials. 1

Side effects

• From clinical trials, the following side effects

were reported significantly more often among

participants receiving cannabinoids than among

controls: dizziness, disorientation/confusion,

euphoria, dry mouth, drowsiness/somnolence,

nausea, fatigue/asthenia. 2

Drug interactions

Note: The lack of a cited interaction does not

preclude the possibility that a drug interaction exists

(and no studies have yet reported an interaction with

that particular drug).

There is evidence of clinically important drugdrug

interactions between cannabis or cannabinoids

and the following medications: chlorpromazine,

clobazam, clozapine, CNS depressants (e.g.,

barbiturates, benzodiazepines), disulfiram, hexobarbital,

hydrocortisone, ketoconazole, MAO inhibitors,

phenytoin, protease inhibitors (indinavir, nelfinavir),

theophylline, tricyclic antidepressants and warfarin. 4

General risks of marijuana use

Note: These mainly represent evidence from

studies of recreational cannabis users focused on

adverse health effects. Only content areas where

there is “substantial” research evidence are presented.

Furthermore, the studies informing the evidence

statements below are “observational” in design, thus,

for most of these statements, causality cannot be

clearly established (e.g., cannabis use and schizophrenia

may “travel together” rather than represent a

causal relationship). Thus, these findings should be

extrapolated with caution, especially in the context of

medical marijuana use.

• There is substantial evidence:

ú That cannabis use is associated with increased

risk of motor vehicle crashes. 1,4

ú That cannabis users, including adolescent and

young adult users, can develop cannabis use

disorder. 4

ú That adolescent and young adult cannabis

users are more likely than non-users to use

and be addicted to illicit drugs in adulthood. 4

ú That frequent cannabis users are more likely

than non-users to have memory impairment

(lasting a week or more after last use). 4

ú That THC intoxication can cause dose-related

acute psychotic symptoms. 4

ú That cannabis use is associated with

development of schizophrenia, with highest

risk among most frequent users. 1,4

ú That frequent cannabis smoking is associated

with chronic bronchitis. 1,4

ú That cannabis smoke contains many of the

same cancer-causing chemicals as tobacco

smoke; 4 however, there is mixed evidence as to

whether cannabis smoking is associated with

lung cancer. 4

ú That THC crosses the placenta and into

fetuses of women who use cannabis during

pregnancy; 4 and THC is present in breast milk

and passes into breastfeeding infants. 4


1. National Academy of Sciences, Engineering, and

Medicine. 2017. The Health Effects of Cannabis

and Cannabinoids: The Current State of Evidence

and Recommendations for Research. Washington,

DC: The National Academies Press. https://doi.


2. Whiting PF, Wolff RF, Deshpande S, et al. Cannabinoids

for Medical Use: A Systematic Review and Meta-Analysis.

JAMA 2015;313:2456-2473.

3. Devinsky O, Cross JH, Laux L, et al. Trial of Cannabidiol for

Drug-Resistant Seizures in the Dravet Syndrome. N Engl J

Med 2017;376:2011-2020.

4. Colorado Department of Public health and Environment.

Monitoring Health Concerns Related to Marijuana in

Colorado: 2016.

More information


• email:

In Memory...

Eve Hoygaard, MS, RN, WHNP

Membership Chair, Colorado Nurses


We honor the memory of and acknowledge the

work of these recently deceased nurses in our state.

Sharing the names and other information about

our nursing colleagues is one way we honor their


BALICH, CHRISTINE, RN (94) passed away in

February 2018. A graduate from Seaton School

of Nursing, she was in the Cadet Nursing Corps.

She spent her entire career at Penrose Hospital in

Colorado Springs.


away in March 2018. She joined the U.S. Army

Nurse Corps during WWII in 1945 to attend Mercy

Hospital in Denver where she later worked.

KNOEPKE, JEAN, RN (87) passed away in

March 2018. She worked in Colorado Springs.

NELSON, BERNICE, RN (95) passed away in

February 2018. She worked as a RN for 33 years.

This included serving 2 years in the US Army during



received RN and MSN at Yale and a Master’s in

Public Health at University. Her career in Public

Health included Colorado State Nursing Director

and Director of the Division of Community Health


WOOLEY, MILDRED, RN (97) was a 1942

graduate of Bethel SON in Colorado Springs. Her

43 year career included different settings prior to

25 years as a Public Health Nurse.

We received information about the death of

those nurses honored above. All of them lived in,

worked in and/or were educated in Colorado.

Membership in the Colorado Nurses Association is

not required for inclusion.

To honor a deceased nurse, RN or LPN, in the

Colorado Nurse, please send basic information (as

full name, city were they worked/lived/received their

nursing education with year of graduation, and/

or area of practice) to Eve Hoygaard (hoygaard@ We reserve the right to edit material

submitted and endeavor to verify all information

included in this column. If you note an error, please

advise us and a correction will be published. Your

assistance will be greatly appreciated.

Seeking RNs and LPNs

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