RN Idaho - May 2018

Official publication of ANA Idaho
Volume 41, • No. 1
Quarterly publication direct mailed to approximately 23,000 RNs and LPNs in Idaho.
May, June, July 2018
from the President...
Kim Froehlich, MSN, RN, NEA-BC
KFroehlich@relias.com
Happy Nurses Week! This is a week that I’ve always
appreciated as a nurse. It reminds each of us to take a
moment and honor our profession, our colleagues, and
ourselves. Nursing has been the number one trusted
profession for the last consecutive 16 years, with
firefighters deservedly ranking number one in 2001.
Nursing is also one of the most diverse professions
in the nation, with opportunities for clinical growth,
professional role expansion, social advocacy, and
leadership, to name just a few of the many areas where
nurses practice using their unique knowledge and
expertise. Personally, I have had the pleasure of having a
very robust, creative, and exciting career in nursing and
it is one that continues to develop as I grow and evolve.
Nursing provides access to a fulfilling and meaningful
career wherever we choose to practice. I encourage you
this Nurses Week to open your mind to the possibilities
within our profession; take time to recognize your own
creative genius and the wealth of knowledge that you
current resident or
Presort Standard
US Postage
PAID
Permit #14
Princeton, MN
55371
as an individual, and as a
nurse have to share in this
world. Whether you work in
a clinical setting, a business
setting, whether you’re a
formal leader, or providing
direct care, you are making Kim Froehlich
an impact on those you serve
while transforming healthcare in this nation every day.
For decades nurses have been recognized for their
dedicated efforts in providing care to those in need.
Nurses provide the lion’s share of the care needed in
clinical settings, and we carry that responsibility with
us as we take our professional skills and expertise where
our passion leads us. That also means that we know
not only what needs to get done, but how to get it done,
and why it needs to get done. We know how to realize
the intended outcome clinically and holistically. This
expertise translates to any work we choose to do where
meaningful, tangible changes are needed. A nursing
Nurses for Idaho!
Nurses Day at the Capitol
Michael McGrane, MSN, RN
mcgraneconsulting@gmail.com
This is the second year, Nurse Leaders of Idaho (NLI)
and ANA Idaho have had an organized presence at the
Idaho State Capitol. Over 30 nurses attended this year’s
Nurses Day at the Capitol, many staying all morning,
including two who came all the way from Coeur d’Alene.
Continuing education hours were offered to those who
attended and meetings with government officials were
encouraged during the event. Several Representatives
and Senators stopped by to gain a better understanding
of the nursing profession and to discuss issues nurses
are concerned about—including current legislation on
protecting nurses in the workplace.
During the morning, nurses took an opportunity to
attend the House Health and Welfare Committee hearing,
from the President continued on page 2
ANA Idaho Legislative Affairs
Committee members from left to
right: Mike McGrane, Anna Rostock,
Kim Popa, and Brie Sandow.
then the group split to attend the Senate and House
floor sessions. During each session, NLI and
ANA Idaho’s presence was recognized by Senator
Maryanne Jordan and Representative Sue Chew to
the full body of the Senate and the House. The Day
at the Capitol not only engaged legislators to learn
about nursing, but also provided an opportunity for
nurses to learn the workings of the legislature and
Nurses for Idaho! continued on page 4
Inside this Issue
FEATURE:
Advocacy in Action
Nurses for Idaho! Nurses Day at the Capitol
Micheal McGrane, MSN, RN
Public Breastfeading Legislation
Adrean Cavener, BS
Nurse Led Implementation
of Family Bonding Time
Julie Finney, BSN, RNC and
Jane Grassley, PhD, RN, IBCLC
ANA Idaho Wishes you a Happy Nurses Week!
Executive Director’s Report
Robin Schaffer, MSN, RN, CAE
SIDS Foundation
Elizabeth Montgomery, BS Ed.
Page 3
Bundled Payments for Care Improvement
Teresa L. Coiner, RN, BSN, MHS
IALN Update
2018 Idaho Legislature Session Wrap-up
Micheal McGrane, MSN,RN
Idaho Breastfeeding Coalition
Cindy Galloway, RDN, LD, IBCLC
Welcome New Board Member
Christine Westrup, BSN
Page 3
Page 4
Randall Hudspeth, Phd, APRN-CNP, FRE, FAANP
Page 7
Page 8
Page 10
Page 11
Page 11
New Home Health Conditions of Participation
Jenni Blendu, RN, MBA
Evidence-Based Screening Practices
for Postpartum Depression
Sydney Parker, MSN, RN
Page 4
Page 5
Page 11
Page 14

Page 2 • RN Idaho May, June, July 2018
from the President continued from page 1
foundation is unique in that it prepares us to be successful
caregivers, team members, contributors, and leaders
in any situation. I encourage you to take a moment this
Nurses Week 2018 and honor yourself for your hard
work, dedication, intelligence, professionalism, success
and for the tremendous meaningful impact you and your
colleagues have made in this world. We also pause to
celebrate all that is to come as we continue to be present,
be thoughtful, offer guidance, support, education, and
care in all that we do every day!
Here is a glimpse of the amazing path our country has
taken toward celebrating nurses at a national level. Enjoy
this summary of how Nurses Week became a national
event, posted by ANA Enterprise at nursingworld.org
(2018).
A Brief History of National Nurses Week:
1953 Dorothy Sutherland of the U.S. Department
of Health, Education, and Welfare sent a proposal to
President Eisenhower to proclaim a “Nurse Day” in
October of the following year. The proclamation was
never made.
1954 National Nurse Week was observed from
October 11-16. The year of the observance marked the
100th anniversary of Florence Nightingale’s mission to
Crimea. Representative Frances P. Bolton sponsored the
bill for a nurse week. Apparently, a bill for a National
Nurse Week was introduced in the 1955 Congress, but no
action was taken. Congress discontinued its practice of
joint resolutions for national weeks of various kinds.
1972 Again a resolution was presented by the
House of Representatives for the President to proclaim
“National Registered Nurse Day.” It did not occur.
JOIN US ON SOCIAL MEDIA
LIKE US ON FACEBOOK
www.facebook.com/IdahoNursesAssociation/
FOLLOW US ON TWITTER AT
@IDAHONURSES
1974 In January of that year, the International
Council of Nurses (ICN) proclaimed that May 12 would
be “International Nurse Day.” (May 12 is the birthday
of Florence Nightingale.) Since 1965, the ICN has
celebrated “International Nurse Day.”
1974 In February of that year, a week was designated
by the White House as National Nurse Week, and
President Nixon issued a proclamation.
1978 New Jersey Governor Brendon Byrne declared
May 6 as “Nurses Day.” Edward Scanlan, of Red Bank,
N.J., took up the cause to perpetuate the recognition of
nurses in his state. Mr. Scanlan had this date listed in
Chase’s Calendar of Annual Events. He promoted the
celebration on his own.
1981 ANA, along with various nursing organizations,
rallied to support a resolution initiated by nurses in New
Mexico, through their Congressman, Manuel Lujan, to
have May 6, 1982, established as “National Recognition
Day for Nurses.”
1982 In February, the ANA Board of Directors
formally acknowledged May 6, 1982 as “National Nurses
Day.” The action affirmed a joint resolution of the
United States Congress designating May 6 as “National
Recognition Day for Nurses.”
1982 President Ronald Reagan signed a proclamation
on March 25, proclaiming “National Recognition Day
for Nurses” to be May 6, 1982.
1990 The ANA Board of Directors expanded the
recognition of nurses to a week-long celebration,
declaring May 6-12, 1991, as National Nurses Week.
1993 The ANA Board of Directors designated May
6-12 as permanent dates to observe National Nurses
Week in 1994 and in all subsequent years.
1996 The ANA initiated “National RN Recognition
Day” on May 6, 1996, to honor the nation’s indispensable
registered nurses for their tireless commitment
365 days a year. The ANA encourages its state and
territorial nurses associations and other organizations to
acknowledge May 6, 1996 as “National RN Recognition
Day.”
1997 The ANA Board of Directors, at the request of
the National Student Nurses Association, designated
May 8 as National Student Nurses Day.
Reference:
ANA Enterprise. (2018). Available: https://www.nursingworld.
org/education-events/national-nurses-week/nnw-history/
ANA Idaho Welcomes New & Returning Members
Athol, Idaho
Denise Struhs
Ana Urbina
Boise, Idaho
Dara Anderson
Jamie Baxter
Morgann Eason
Deborah Fleischmann
Brenda Kay Gregorio
Dori Healey
Kelly Krommenhoeki
Noel Morin
Tyler Nelson
Duke Nyarecha
Angela Phillips
Kristin Prescott
Kadie Randel
Kathy Satter
Gary Trakas
Rex Underwood
December 2017 – February 2018
Caldwell, Idaho
Nilda Matos Kelly
Jodi Thompson
Colleen Weeks
Coeur D’Alene, Idaho
Masako Sato
Carol Williams
Eagle, Idaho
Debra Chase
Emmett, Idaho
Robyn Moulton
Fruitland, Idaho
Hilary Heller
Hailey, Idaho
Traci Vanhorn
Hayden, Idaho
Kara Adams
Irwin, Idaho
Michelle Kellar
Kuna, Idaho
Crystal Belcourt
Lorrie Jacoby-Torrey
Linda Mansfeld
Chasity Small
Meridian, Idaho
Troy Allbright
Aya Andrews
Brenda Berger
Jenny Boone
Sheila Desilet
Elizabeth Larsen
Shanda Morris
Linda Petersen
New Plymouth, Idaho
Tamie Verbance
Pocatello, Idaho
Jennifer Caldwell
Post Falls, Idaho
Christy Stephens
Preston, Idaho
Suzanne Campbell
Rigby, Idaho
Vicki Eckersell
Soda Springs, Idaho
Rita McEwen
Spring Branch, Texas
Melissa Hale
Twin Falls, Idaho
Jennifer Hainer
Alex Luna
RN Idaho is published by ANA Idaho
1850 E. Southern Ave., Ste. 1,
Tempe, AZ 85224
Toll-free Phone: 888-721-8904
Direct Dial: 404-760-2803 Extension: 2803
Email: rnidaho@idahonurses.org
FAX: 404-240-0998
Website: www.idahonurses.org
Editorial Board:
Carrie Anstrand, MA, BSN, RN, LCCE, IBCLC, Editor
Susan Cline, DNP, MBA, RN, NEA-BC
Margo Hickman, BSN, RN
Beverly Kloepfer, MSN, RN, NP-C
Barbara McNeil, PhD, RN-BC
Sydney Parker, MSN, BSN, RN
Katie Roberts, MSN, RN
Robin Schaeffer, RN, ANA Idaho Executive Director
(advisory)
Mark Siemon, Ph.D., RN, APHN-BC, CPH
Christine Westrup, BSN
RN Idaho welcomes comments, suggestions,
and contributions. Articles, editorials and other
submissions may be sent directly to the ANA Idaho
office via mail, fax, or e-mail. Please call the ANA
Idaho office if you have any questions.
Join ANA Idaho Today
We need you!
Membership application
http://nursingworld.org/joinana.aspx
For advertising rates and information, please
contact Arthur L. Davis Publishing Agency, Inc., 517
Washington Street, PO Box 216, Cedar Falls, Iowa
50613, (800) 626-4081, sales@aldpub.com. ANA
Idaho 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 ANA Idaho of products
advertised, the advertisers, or the claims made.
Rejection of an advertisement does not imply a
product offered for advertising is without merit, or
that the manufacturer lacks integrity, or that this
association disapproves of the product or its use. ANA
Idaho and the Arthur L. Davis Publishing Agency, Inc.
shall not be held liable for any consequences resulting
from purchase or use of an advertiser’s product.
Articles appearing in this publication express the
opinions of the authors; they do not necessarily reflect
views of the staff, board, or membership of ANA
Idaho or those of the national or local associations.
RN Idaho is published quarterly every February,
May, August, and November for ANA Idaho, a
constituent member of the American Nurses Association.

May, June, July 2018 RN Idaho • Page 3
Executive Director’s Report
ANA Idaho Celebrates You!
Robin Schaffer, MSN, RN, CAE
Executive Director, ANA Idaho
robin@aznurse.org
We appreciate our nurses every day, but Nurses Week is
a great opportunity to take the time to celebrate. We take
pride in the fact that the public has rated nursing as the
most honest and ethical profession for the past 16 years.
Therefore, it is only fitting that we take one week each
year to celebrate our profession and the vital roles nurses
play in health care.
National Nurses Week begins each year on May 6th
and ends on May 12th, Florence Nightingale’s birthday. It
features a host of events across the U.S. to honor nurses
for the work they do and educates the public about nurses’
role in health care. While the first National Nurses
Week was celebrated in 1954 – the 100th anniversary of
Nightingale’s famous mission to the Crimea – it wasn’t
until President Ronald Reagan signed a proclamation that
May 6th would henceforth be National Nurses Day and
that the annual celebration of nurses’ efforts would be
nationally recognized.
The American Nurses Association (ANA) has always
led efforts to celebrate nursing, ensuring that recognition
is promoted as widely as possible, and in 1990 extended
it to a week-long celebration of the work of the nation’s
registered nurses, the largest workforce of the health care
professions. Every year ANA selects a theme for the week
highlighting an aspect of nurses’ practice. This year’s
theme is “Nurses: Inspire, Innovate, Influence.”
How are you planning to celebrate Nurses Week this
year? One great way is to join ANA on May 9, 2018 at
11AM Mountain Time for the FREE 2018 National
Nurses Week Live Webinar, ‘Emerging Technology
and Its Impact on Nursing Practice.’ Technology in
healthcare is continually evolving. What is coming
down the pike? What does the
future of nursing look like?
What do nurses need to know
to adapt? More information Robin Schaeffer
is available at: idahonurses.
org/2018NNWwebinar
During National Nurses Week, the ANA Idaho Board
of Directors would like to extend a special thanks to you,
our Idaho nurses, as you continue to provide the highest
level of quality care to your patients. You deserve special
recognition for your efforts to inspire, innovate, and
influence! If you are not yet a member of ANA Idaho,
please consider joining us at http://www.idahonurses.org/.
State membership includes national membership to the
American Nurses Association!
-Robin
Reference:
American Nurses Association. (2018). National Nurses
Week 2018. Retrieved: https://info.nursingworld.org/
nationalnursesweek2018/
GRADUATE CERTIFICATE in PUBLIC HEALTH
The Graduate Certificate in Public Health is an 18-credit program
that is designed for working professionals and graduate students
who would like to expand their knowledge of public health.
The Graduate Certificate in Public Health curriculum includes
courses that address the public health core knowledge areas of
biostatistics, epidemiology, social and behavioral sciences, health
services administration, and environmental health sciences. Online
and in-person class options available.
For more information, contact
Maren Nelson at 208-282-2729.
Protecting Families Since 1997
208-880-3044 • 208-467-4675
growinsurance@gmail.com
Offering Long Term
Care Insurance
• Medicare Supplements
• Critical Healthcare Plans
• Life Insurance - living
benefit options
Blaine is a broker who has been “Grow Old Gracefully”
an advocate for Nurses and their
families in planning for long term
care, life, and medicare supplements.
www.blainegrowinsurance.com
2122 S. Secretariat Way Nampa, ID 83686

Page 4 • RN Idaho May, June, July 2018
Advocacy in Action
Every Mother Has the Freedom
to Feed Her Baby
Adrean Cavener, BS, Lobbyist
adreancavener@gmail.com
After a lot of hard work from advocates from across
the state, H.B. 448 became law this legislative session.
This bill gives protection to breastfeeding mothers from
the indecent exposure statute. H.B. 448 worked its way
from the House to the Senate without a single “nay” vote,
and the Governor signed it into law shortly after. It was
truly incredible to see mothers with their sweet children
in committee rooms during hearings to lend their support
for the bill. (Many legislators even commented that it
was an unfair advantage…) So, after years of work on the
issue and countless hours from volunteers and supporters
since 2003, mothers across the state can finally rest easy
that they can now nurse in public without the threat of
legal action. A special thanks to Representative Paul
Amador for his leadership in moving this bill forward to
a successful signing! We would also like to thank ANA
Idaho for their support of this important bill for Idahoans.
For specific language and session activity, you can find
H.B. 448 at https://legislature.idaho.gov/sessioninfo/2018/
legislation/. Also, do not hesitate to contact your local
legislator and thank him/her for their support of this
monumental legislation.
Representative Amador with his son Peter.
Many mothers, families, community members,
lactation consultants and nurses came in
support of the bill.
Photo credit: Senator PattiAnne Lodge
Representative Paul Amador (R) testifying in the
Senate Committee Hearing on H.B. 448 while
holding his 6 month old son, Peter.
Nurses for Idaho! continued from page 1
Senator Maryanne Jordan and Representative Sue
Chew to the full body of the Senate and the House. The
Day at the Capitol not only engaged legislators to learn
about nursing, but also provided an opportunity for nurses
to learn the workings of the legislature and the difficult
process for a bill to become a law. Thank you to everyone
who participated, especially those who braved the heavy
snow so early to help set-up!
To learn more and get involved making a difference
for nursing in our state, consider joining the Legislative
Affairs Committee with ANA-Idaho! Contact Anna
Rostock at rostocka@slhs.org or Michael McGrane at
mcgraneconsulting@gmail.com. We look forward to
hearing from you!
Bundled Payments for Care
Improvement (BPCI) Initiative:
The role of nurse navigators and how
they fit in with the initiative
Nurses come from around the state to
participate in “Nurses for Idaho!”
Nurses Day at the Capitol 2018
Teresa L. Coiner, RN, BSN, MHS
Nurse Navigator, Saint Alphonsus-Nampa
Teresa.coiner@saintalphonsus.org
All nurses are navigators. When we first step into a
patient room, we literally become their navigator. Managing
a patient’s course of care right from the very beginning is a
positive step that directly impacts his clinical outcome. The
Bundled Payments for Care Improvement (BPCI) initiative
was implemented at both Saint Alphonsus Boise and Nampa
locations in 2015. This initiative is a patient-centered
strategy: the navigator facilitates efficient health care access
by using their nursing skills to manage a patient’s course of
care (Centers for Medicare & Medicaid Services, 2018).
As navigators in a hospital setting, we meet with patients
to set collaborative goals of care with the patient and their
family/support system. The ultimate goal is nearly always
to get patients back home after hospitalization, however,
occasionally the next best site of care may be a skilled
nursing facility or their condition may require setting up
home health services. In general, as nurse navigators,
we provide the following services: a) education to guide
patients through the disease process, b) education on
treatment options and understanding the recovery process,
c) access to community resources and medical equipment,
d) medication review, e) access to psychological and clinical
support, f) coordination with primary care providers
and other specialists, and g) home visits. As BPCI nurse
navigators, we make important contributions to improve the
quality of life, quality of care, and efficiency of resource use
for our medically complex patients.
The following is a case study that demonstrates the
importance of the BPCI nurse navigator role. 82 year-old
Mrs. Smith was admitted to the hospital for congestive heart
failure (CHF) and pneumonia. During her stay, she was
assigned a nurse navigator due to her medical complexity
and because she lives alone, has limited family support and
doesn’t drive. At the time of discharge, Mrs. Smith was given
orders for a home health agency to provide physical therapy,
nursing care, and a bath aide. The assigned nurse navigator
called Mrs. Smith post discharge and discovered that home
health had not yet been initiated, prompting the navigator to
provide a home visit that afternoon. Mrs. Smith was pleased
not only that she had met the nurse navigator during her
hospital stay but that her complex needs were being met and
she was not “falling through the cracks” of the system.
At the home visit, the navigator discovered multiple
medication discrepancies, one being that the patient was
taking over 1000 mg of aspirin a day. Additional observations
revealed that the CHF patient had a “bag full” of medications,
lots of chips and nuts within reach, and the patient did
not have a scale to weigh herself daily. The Navigator
called the patient’s PCP (primary care provider) and had
medications clarified, set up an office visit, and then arranged
transportation through the Saint Alphonsus Express van. At
the time of the scheduled PCP appointment, the navigator
attended the appointment with the patient. In addition, the
navigator provided the patient with a scale so she could weigh
herself daily and then taught Mrs. Smith to use a daily log
called the Zones to Manage Heart Failure-Green-Yellow-
Red; which is a daily log for tracking weight, heart rate, blood
pressure and shows what “zone” they are in for the day.
After weekly calls and several home visits, the
navigator was not only able to keep the patient from
being readmitted to the hospital, but also helped her to
better manage her congestive heart failure. The impact of
the Bundled Payments for Care Improvement Initiative
Nurse Navigator role is an exciting and critical one for
maximizing the health of patients as they navigate the
complexities of our health care system.
Reference:
Centers for Medicare & Medicaid Services. (2018). Bundled
Payments for Care Improvement Initiative (BPCI) Fact
Sheet Retreived: https://www.cms.gov/Newsroom/
MediaReleaseDatabase/Fact-sheets/2015-Fact-sheetsitems/2015-08-13-2.html
Left to right: Anna Rostock, Barbara Hocking,
Brie Sandow, and Kim Popa
Participants visit the House and Senate floor

May, June, July 2018 RN Idaho • Page 5
Nurse Led Implementation of a Family Bonding Time
Julie M. Finney BSN, RNC, Mother/Baby Unit,
St. Luke’s Meridian Medical Center
Jane Grassley PhD, RN, IBCLC, School of
Nursing, Boise State University
finneyj@slhs.org
The day starts at 7:00 AM on our 13-bed Mother/baby
unit, with bedside report to the oncoming shift. The new
parents may have been up all night feeding their baby
and now it’s morning and they have a revolving door
of interruptions. They may see up to 13 different people
from the medical providers to the photographer, as well
as family and visitors during the day. These interruptions
do not include the couplets’ nurse or certified nursing
assistant (CNA) making hourly rounds, assessments, and
administering medications. This is a significant problem
(Adatia, Law, & Haggerty, 2014). One study found that
new mothers experienced an average of 53 interruptions on
postpartum day one (Morrison & Ludington-Hoe, 2012).
To address this problem, St. Luke’s Meridian Medical
Center implemented a Family Bonding Time (FBT).
Our goals were to allow parents to have a specific time
during the afternoon to spend with their baby without
interruptions and to improve exclusive breastfeeding
rates. This article describes the process of meeting these
goals which involved changing the culture of the unit and
inviting the staff to be part of the process (Skelton-Green,
Simpson, & Scott, 2007).
The team-based educator recruited four nurses, two from
day shift and two from night shift for the implementation
team. The Women’s Services Administrator funded each
member a total of 4 hours for this work. The next step
involved planning our implementation strategy. First,
we defined allowable activities during FBT, such as
patients ordering lunch or calling for pain medications,
breastfeeding help, or other concerns. Unacceptable
activities included unnecessary noise and non-urgent tasks
or procedures for mother or baby. We then strategized
how to communicate this culture change. The Marketing
Department helped us reach a wider audience about FBT
within our system and community through the health
system e-newsletter and blog. They formatted a flyer and
banner that explained FBT to families and visitors in our
waiting area. Team members delivered flyers to provider
clinics and childbirth educators to share with families.
Laminated door signs were posted outside mothers’ rooms
for those participating in FBT.
Next, we created a plan to inform our unit staff and other
departments about FBT and the anticipated “go live” date.
We presented FBT at a unit meeting with an explanation
of the concept and allowed time for questions. For the
other departments, each member of the team met, phoned
or emailed the director or supervisor of their assigned
departments within the hospital. Departments agreed to
complete their specific daily tasks in the mornings, prior
to the 2:00 PM start time of FBT. This included pediatric
and obstetrical providers, photo staff, car seat technicians,
and hearing screeners. Environmental Services (EVS)
had concerns that their cleaning, garbage pickup and linen
delivery conflicted with FBT hours. We met to discuss the
benefits of FBT and worked out a plan to change garbage
pickup and linen delivery times. EVS agreed to not clean
rooms during FBT unless the need was critical. After 2
months of planning, we implemented FBT, which was
facilitated by having a planning team member available each
Great Careers Start at at Lourdes.
Registered Nurse
Emergency Department
Inpatient Rehab
ICU
For additional opportunities please visit our website.
Lourdes Employment Office
Lourdes Employment Office
520 N. 4th Ave.
520 N. 4th Ave.
Pasco, WA 99302-2568
Pasco, WA 99302-2568
PH (509)546-2283
PH (509) 546-2283
FAX (509) 546-2296
FAX (509) 546-2296
yourlourdes.com Equal Opportunity Employer
Equal Opportunity Employer
day shift to remind staff to speak to their families about FBT
and schedule patient care before or after FBT. Planning team
members supported staff from other departments in making
alternative arrangements for unit’s work.
Our implementation of FBT was successful with
positive outcomes. Mothers and families have commented
that they appreciate the time without visitors. Exclusive
breastfeeding rates increased from 67% to 87%.
Environmental services, pharmacy, and dietary services
successfully changed their routes and times of delivery.
The unit staff use FBT to catch up on charting, read email,
complete education modules, or take a lunch break. Staff
are also able to focus on new admits or discharges while
their other mothers are participating in FBT.
Even with a successful implementation of this nurse
driven improvement, reminders may be needed, including
to ancillary department personnel. Noise at the nurses’
Please call Human Resources for questions
or more information at 541-575-4192
Explore or Apply Online:
station continues to be a challenge. Sustaining FBT
involves ongoing education, including orientation for
new unit and hospital staff, and reminders to all staff of
its importance. Providing FBT for our families is vital
to help provide a private time to bond with their infants.
Nurses must commit to improving the environment within
hospitals to promote family bonding and patient and
family centered care.
References
Morrison, B., & Ludington-Hoe, S. (2012). Interruptions to
breastfeeding dyads in an LDRP unit. The American Journal
of Maternal Child Nursing, 37(1), 36-41.
Adatia, S., Law. S., & Haggerty, J. (2014). Room for
improvement: noise on a maternity ward. BMC Health
Services Research, 14(604). doi: 10.1186/s12913-014-0604-3
Skelton-Green, J., Simpson, B., & Scott, J. (2007). An integrated
approach to change leadership. Nursing Leadership, 20(3).
WORK-LIFE BLEND
Come see for yourself.
You BELONG here!!
Expand Your Career
Blue Mountain Hospital District, a Critical Access Hospital which serves
the Grant County region. Located in beautiful eastern Oregon. We have
an incredibly dedicated and dynamic team based environment.
Currently Seeking
• Experienced RN (Associate or BSN) – ER, OB, OR, Med Surg
(Full-time, Part-time and Casual positions available)
• RN, LPN/LVN and CNA (Intermediate Care Center/Nursing Home)
• Physical Therapist (Outpatient/Home Health)
• Director of Nursing Services (Intermediate Care Center/Nursing Home)
• Quality and Performance Improvement Director (Healthcare)
• Clinic Director (Family Practice Rural Health Clinic)
Best Benefits
• Benefits include Retirement Plan with
Employer Match
• Generous PTO
• Advancement Opportunities
• Nursing Shift Differential
• A lifestyle of enjoying the outdoors
in a quiet, remote & rural community.
“Quality Healthcare Close to Home”
EOE/AA We support a tobacco free and drug free workplace.
www.bluemountainhospital.org
Seattle
Portland
Salem
Eugene
Bend
Location
John Day, Oregon
Spokane
John Day
Boise

Page 6 • RN Idaho May, June, July 2018
Idaho Board of Nursing Update
Sandra Evans, M.A.Ed., RN,
Executive Director
Sandra.Evans@ibn.idaho.gov
By the time you read this “Update from the Board of
Nursing,” the Second Regular Session of the 64th Idaho
Legislature will very likely have adjourned “sine die”
(Latin for “without day,” or “without a fixed day for
further meeting or action.”) The Board’s pending rules,
having been approved by the Legislature early in the
Session, will become final on adjournment. These adopted
changes to the Administrative Rules serve to clarify
processes for enrollment in the Program for Recovering
Nurses (PRN) and requirements for nursing program
faculty and administrators—changes necessary to keep
nursing regulation in Idaho relevant and responsive to
changes in nursing regulation.
The Administrative Rules of the Idaho Board undergo
some form of revision nearly every year, for example:
• In 2017, rule revisions 1) allowed for MD and PA
preceptors for APRN students, thereby expanding
clinical opportunities; and 2) authorized the use
of electronic addresses for purposes of Board
communication with licensees;
• In 2016, rule revisions 1) implemented the requirement
for demonstrated continued professional development
for LPN and RN license renewal beginning with the
2018 LPN renewal; and 2) amended requirements for
RNs practicing in a specialty area;
• In 2015, rule revisions clarified what constitutes sexual
misconduct as grounds for disciplinary action against a
nurse’s license;
• In 2014, rule revisions 1) provided for interfaces other
than delegation in which licensed nurses engage; e.g.
teaching, guiding, consulting, advising; and 2) deleting
the list of specific tasks that should not be delegated by
a licensed nurse to unlicensed assistive personnel;
• In 2013, rule revisions amended the titles and
abbreviations for registered nurses (formerly “licensed
professional nurse” abbreviated “RN”) and advanced
practice registered nurses (formerly “advanced practice
professional nurse” abbreviated “APPN”) for full
alignment with the national Consensus Model for
APRN Regulation.
In addition to reviewing/revising its rules, the Board
of Nursing continually assesses the relevance of Idaho’s
nursing laws to assure they remain responsive to emerging
trends and changes in the regulatory environment. In fact,
since its creation in 1911, the Idaho Nursing Practice Act
(NPA) has been amended no less than 30 separate times.
At the writing of this “Update,” it’s too early to know if
the Board’s 2018 proposed changes to the Nursing Practice
Act will have been adopted by the Legislature. However,
if so, criteria for RN members of the Board will have been
amended to be more consistent with those for LPNs and
APRNs—specifically, all licensed nurse candidates must
be US and Idaho citizens, must live in and be licensed in
Idaho, and be actively practicing nursing in Idaho at the
time of appointment to the Board.
Recent significant changes to the Idaho Nursing
Practice Act include:
• Revision of the definition of “Practice of Nursing” in
2016 to clarify that practice occurs at the location of the
recipient of services and includes “a broad continuum
of services delivered in healthcare and non-healthcare
environments for remuneration or as volunteer service,”
• Adoption of the “enhanced” Nurse Licensure Compact
and APRN Compact in 2016 to be implemented when
the respective thresholds are met (NOTE: the Nurse
Licensure Compact [NLC] was implemented on
1/19/2018, replacing its predecessor NLC);
• Granting the Board authority in 2013 to share
investigative information with other regulatory boards
and law enforcement; and
• Granting the Board authority in 2012 to 1) administer
an alternative to discipline for practice remediation and
2) use dedicated funds to support workforce–related
initiatives.
Although the outcome is not yet known for 2018
legislation that might impact the Board, including bills
introduced by the Board as well as bills introduced by
others, one thing is certain...in Idaho, change is inevitable.
Consistent with its “Philosophy of Governance,” the Board
strives to initiate change that most effectively upholds its
Mission of public protection and ensures major decisions
and day-to-day activities are guided by core values and
beliefs. In a nutshell, the Idaho Board continually pursues
innovation and best practices in nursing regulation.
In concert with each annual legislative session, the nine
appointed members of the Idaho Board of Nursing meet at
least quarterly for the conduct of regular business. Current
Board members include Vicki Allen, RN, Pocatello, Chair;
Carrie Nutsch, LPN, Jerome, Vice Chair; Jennifer Hines-
Josephson, RN, Rathdrum; Whitney Hunter, Consumer,
Boise; Jan Moseley, RN, Coeur d’Alene; Rebecca Reese, LPN,
Post Falls; Clay Sanders, APRN, CRNA, Boise; Merrilee
Stevenson, RN, Wendell; and Reneé Watson, RN, Boise.
Business of the Board centers around responsibilities
related to licensure, practice, education, discipline and
alternatives to discipline, communication, governance and
organization. At their meeting on January 18-19, 2018,
Board members:
• Reviewed correspondence and reports of external
meetings attended by both members and staff;
• Adopted proposed revisions to existing Board policies
related to the Board’s Code of Ethics and Conduct, and
requirements for a U.S. Social Security Number and
declared primary state of residence by applicant’s for
Idaho nurse licensure;
• Took action to recognize APRN national certifying
organizations that meet criteria as defined by the
National Council of State Boards of Nursing for
purposes of APRN certification related to role and
population focus, a requirement for APRN licensure in
Idaho;
• Accepted reports and recommendations from the
Board’s APRN and PRN Advisory Committees;
• Finalized plans for the 2018 Board Business Retreat to
be held May 18th in Boise; and
• Took action to:
• Revoke an LPN license for violations of standards
of practice and conduct;
• Deny a petition for early release from monitoring
through the Program for Recovering Nurses (PRN);
• Authorize continuation in the PRN under original
terms and conditions with a “reset” of the 5-year
period of monitoring for a nurse following a single
incident of non-compliance; and
• Fully reinstate a previously disciplined LPN license
having determined the applicant’s successful
completion of requirements for reinstatement
defined in the original discipline order.
The Board wishes to encourage nurses to complete a
brief, anonymous on-line survey accessible on the Board’s
website at https://ibn.idaho.gov/IBNPortal/ before May
1, 2018 to assist the Board in complying with Lieutenant
Governor Brad Little’s Executive Order No. 2017-06,
requiring a review of Idaho’s occupational licensing
requirements (available at https://www.ibsp.idaho.gov/
EO%202017-06.pdf). Results of the survey will be
reported in the aggregate as part of the Board’s report to
Lieutenant Governor Little this coming spring.
As always, the Board invites the public to attend
scheduled Board meetings and participate in the Open
Forum held on the second day of each meeting. The
Open Forum provides the opportunity to dialogue with
the Board on issues of interest that are not necessarily
included on the published agenda. The Board will not take
action on issues introduced during the Forum, but may
choose to address them at a later scheduled Board meeting.
The next meetings of the Board are tentatively
scheduled for July 26-27 and November 1-2, 2018
in Boise at a location to be determined. For further
information, visit the Board’s website or contact the Board
office at 208.577.2476.

May, June, July 2018 RN Idaho • Page 7
IALN Update
Ominous Future for the Idaho Nursing Workforce
Randall Hudspeth, PhD, APRN-CNP, FRE, FAANP
Executive Director, IALN and NLI
randhuds@msn.com
Idaho nurses have seen many shortages come and go
with varying predictions of a gloomy future each time.
History is helpful to teach us the causes and remedies
of each shortage as it happened in its own era, but the
common response throughout time to solve a shortage
has been to increase the production of new nurses. Three
things have been both a blessing and a curse for nursing:
disease, war and shortage. Each resulted in more attention
to an insufficient nursing manpower supply and called
for additional funding in terms of scholarship, academic
opportunity and salary.
The first statewide nursing shortage was documented
in 1918 when each state was asked to submit an inventory
of trained nurses for the WWI effort. There was no way
to determine how many nurses lived in Idaho because
licensure was voluntary at that time. Immediately after
the war, returning soldiers and a more mobile population
brought the Spanish flu to Idaho and many nurses died and
others declined work for fear of catching it. No community
was hit harder than Lewiston, where seven Catholic nursing
sisters died depleting the hospital nursing staff. To keep the
hospital open it started a nursing program. A 1918 Idaho
Statesman headline stated “Idaho Nurses in Big Demand”
(Charting Idaho Nursing History, 2009, pp. 39-40).
History repeated itself in WWII when many Idaho
schools affiliated with the Cadet Nurse Corps began paying
students who then joined the military. After the war nurses
came home, many got married, raised families and did not
work. The national polio epidemic happened soon after and
nurses again resisted returning to work for fear of taking
polio home to their children. A 1947 Idaho Statesman
headline read “St. Luke’s to Close 10 Beds Due to Nurse
Shortage” (Charting Idaho Nursing History, 2009, pp. 86-98).
In 2002, the federal government’s national nursing
workforce eight year projection alerted us to an impending
2010 shortage. The 2008 economic downturn helped delay
that shortage alarm. Now, both nationally and in Idaho,
there is a growing awareness that we have a big nursing
workforce crisis in our near future that will negatively
impact the healthcare of Idaho citizens. There are multiple
reasons why this is happening again and the Idaho Nursing
Workforce Center, housed at IALN, is taking action to
help mitigate shortage issues. In February, 45 stakeholders
representing nursing education, long term care, large
hospital systems, critical access hospitals, Idaho Hospital
Association, Board of Nursing, and Idaho Department of
Labor, met in Boise to review the current status of Idaho’s
nursing workforce.
The primary reasons for Idaho’s impending shortage
are the demand for nursing care by an increasingly sick
and elderly state population, the aging Idaho nursing
workforce, and the lack of nurses migrating into Idaho
to fill vacancies. The Federal Bureau of Labor Statistics
projects nursing to be the most needed profession by
2022 (only 4 years from now) with 525,700 replacement
nurses needed to maintain the 3.2 million national nursing
workforce (2018).
On December 20, 2017, a National Census Bureau
report identified Idaho as the nation’s fastest growing
state with a more than 2% population increase in one year,
mostly in the Treasure Valley (U.S. Census Bureau, 2017).
The influx of new Idaho residents are commonly older
than 55 years, have limited years of employment left in
their careers, and are coming from more heavily populated
states with a future plan to retire in Idaho. Because of their
numbers and ages we can project increasing demands on
Idaho’s healthcare services.
Workforce impact has two parts: (1) the supply of
nurses to work, and (2) the number of jobs to be filled.
According to the Idaho Department of Labor (2017),
Idaho’s supply of LPNs has remained constant for almost
20 years with 3,268 reported in 1997 and 3,650 reported in
2017. The supply of RNs has grown by about 670 each year
from 9,489 in 1997 to 23,046 in 2017. However, the RN
supply number has a skew because of nurses who live in
states that do not participate in the nurse license compact,
such as Washington, Oregon and California. Because
these nurses provide remote nursing services, such as
case management or telemedicine, to patients living in
Idaho, these out-of-Idaho nurses must have a single state
Idaho license to provide these services. For workforce
inclusion purposes, they do not physically reside in Idaho
and are not available to work in Idaho unless they move
to Idaho. Thus, the actual resident RN workforce in 2017
was 17,411 versus the 23,046 total licensed. Of the 17,411
only 16,402 reported they were employed. That leaves an
effective available employment pool of nearly 1,000 RNs,
recognizing that these nurses may retain their license
and yet have no plans to work in traditional nursing roles
(Idaho Department of Labor, 2017).
Age evaluation for both LPNs and RNs is a good
indicator of future workforce capacity. Both LPN and RN
groups have significant older age groups that are similar.
The report on nursing by the Idaho Department of Labor
states that for LPNs, 34.8%, or 1,270 of 3,650 currently
licensed are 55 years or older (2017). For RNs, 34.6%, or
6,024 of 17,411 currently licensed are 55 years or older.
Even more concerning for the RN population, 12.6%, or
2,193 of 17,411 are age 65 or older and can be expected
to retire when they reach full retirement age of 66 years
(Idaho Department of Labor, 2017).
How is the need for nurses determined? There is
a national standard ratio that calls for 10.35 full-time
working RNs per 1,000 population. Idaho has a population
of 1,654,930 and 16,402 working nurses, which yields
a nurse ratio of 9.91 per 1,000 population. To meet the
standard for this population, Idaho needs 17,128 RNs
working full time. Based on currently reported numbers
Idaho is short by 726 RNs, and the need may be higher
due to the inability to determine the number of part-time
employed nurses (Bureau of Labor Statistics, 2018; Idaho
Department of Labor, 2017).
Using the population based need factor with projected
census increases and applying an exponential decay
methodology for retirements between 2018 and 2024 to
gauge an annual impact, two determinations can be made.
They are (1) how many nurses Idaho needs to produce or
recruit into Idaho to replace retirements, and (2) how many
additional nurses Idaho needs in order to provide care to an
increasing and aging population. The results of these two
calculations show that 4,393 RN’s will retire in the next 6
years, leaving a 12,009 incumbent RN workforce; while the
demand from census growth calls for a total RN workforce
of 19,665. Thus, there is a total replacement need of 7,656
RN over the next 6 years or a yearly demand of 1,276
nursing replacements (Idaho Department of Labor, 2017).
Historically, the 10 Idaho RN nursing schools
graduate an average of 800 students yearly. Based on
nurse migration history, we cannot count on in-migration
of nurses to Idaho to meet the need and we must look
at increasing nursing school graduations. This poses a
significant challenge in that each school will need to
increase graduates by 47 students on average annually
(Idaho Department of Labor, 2017).
What are Idaho’s risks to meeting this need? (1) There
are some Idaho nursing school graduates who are outof-state
residents and who came to Idaho only to attend
college. This graduate group commonly has no plan to
reside in Idaho permanently. (2) All of the surrounding
states currently report similar census growth and need
Intermountain Hospital is recruiting for our
Psychiatric Nursing Team
Come be a part of the RN team at Intermountain, a
behavioral healthcare facility in beautiful Boise, ID.
Bachelors/Associates degree
Please go to our website to
review and apply online for
our job openings.
www.intermountainhospital.com
Ask about our
sign-on bonus
& student loan
repayment
programs for FT
positions.
for nurses. Washington and Oregon combined predict a
nursing shortage of up to 6,000 nurses during this same
time (Bureau of Labor Statistics, 2018). (3) All of the
surrounding states report nursing salaries that are greater
than Idaho pays (Idaho Labor Department, 2017). (4) Over
the past 10 years we have evidence of a nurse graduate outmigration
from Idaho of about 250 each year (Bureau of
Labor Statistics, 2018). (5) Idaho continues to experience
a long standing mal-distribution of the nursing workforce
with rural and critical access hospitals facing difficult
recruitment and retention issues (Idaho Labor Department,
2017). (6) Clinical experience sites are limited, making
it difficult for nursing schools to accommodate more
students. (7) Nursing faculty salaries are low, making
recruitment of qualified educators difficult. Qualified
nurses often choose not to teach because they have
significantly higher salaries working for hospitals and
agencies (Idaho Labor Department, 2017). (8) Faculty
are nearing retirement age and will retire sooner and
in greater numbers than the general nursing workforce,
resulting in a loss of experienced educators that will not
be easy to replace (Idaho Labor Department, 2017).
(9) Idaho also faces a provider shortage, and nurses
seeking graduate degrees most commonly become nurse
practitioners, helping meet the provider shortage versus the
nursing shortage.
Resolution of these issues will not be easy. There
are sufficient qualified student applications to fill the
vacancies so focusing on encouraging students to consider
nursing as a career is not needed. In fact, some schools
report up to 10 well qualified applicants for each available
position. The issues of finding and increasing clinical
space for training opportunities, recruiting qualified
nurses to work as clinical faculty, paying nursing faculty
adequate salaries to prevent them from leaving teaching
for higher paid clinical jobs, and increasing staff nurse
salaries to compete with surrounding states are all key
issues that need to be addressed in order to successfully
secure the nursing workforce for the future of Idaho.
References:
Bureau of Labor Statistics, U.S. Department of Labor. (2018).
Occupational Outlook Handbook, Registered Nurses.
Retrieved from: https://www.bls.gov/ooh/healthcare/
registered-nurses.htm
Idaho Department of Labor. (2017). Idaho Nursing
Overview: An interim report. Idaho Department of Labor
Communications & Research. Retrieved from: https://labor.
idaho.gov/publications/NursingOverview2017.pdf
Kaiser, V., & Hudspeth, R. (2009). Charting Idaho Nursing
History. (pp. 39-40, 86-98). Boise, Idaho: VKRHPubs, LLC.
United States Census Bureau Reports. (2017). Idaho is Nation’s
Fastest-Growing State, Census Bureau Reports. Retrieved
from: https://www.census.gov/newsroom/press-releases/2017/
estimates-idaho.html
Boise, Idaho
BE A PART OF A GREAT TEAM!
Idaho State University’s
School of Nursing
Temporary Simulation Technology
Specialist
For more information or to apply, email
your resume to
bakeaut2@isu.edu
Part-Time, Temporary position, no benefits,
RN licence required
ISU is an equal opportunity/affirmative action employer. We have an
institution-wide commitment to inclusion and diversity and encourage
all qualified individuals to apply. Veterans’ preference. Upon request,
reasonable accommodations in the application process will be provided
to individuals with disabilities.

Page 8 • RN Idaho May, June, July 2018
2018 Idaho Legislature -
Session Wrap-up March 29, 2018
Michael McGrane, MSN, RN
Lobbyist for ANA Idaho and the Nurse Leaders of Idaho (NLI)
Email: mcgraneconsulting@gmail.com
The 2018 Idaho Legislative Session finished on Wednesday, March 28th. The Session
moved more bills than any other session in recent history. This was driven by a
year where every senate and representative position is up for re-election. Many
are seeking higher office or retiring. Those running for re-election are occupied with
campaigns in advance of the primary election on May 15th. It has also been a highly
organized session. Senate and House leadership have moved bills more efficiently
through the convoluted process of bill introduction, committee and floor hearings
in both houses, then to the Governor’s office. Even factions within the legislature were
more organized and strategic this year. Following an Idaho Supreme Court decision on
the deadline for the Governor’s veto of a bill, the legislature stayed an extra week for the
Governor to complete signing bills. A total of 558 bills were introduced.
H464 The Idaho Health Care Plan bill would have allowed the state to apply to
the federal government for two waivers to the Affordable Care Act. It was sent back to
committee earlier in the session, essentially killing the bill without a vote. It was then
resurrected late in the Session when the House Health and Welfare Committee voted 7 to
5 to send the bill back to the House floor for a vote. This followed a rally by hundreds of
Idahoans to push for a solution for those excluded from Medicaid or coverage through the
Idaho Exchange. Regrettably, the House again sent the bill back to the committee without
a vote. Once again, now six years in a row, the Idaho legislature failed to address
those caught in the health insurance Gap.
Another rally that drew media attention this year was one where marchers used small
coffins to protest the religious exemption to the Child Welfare Act. The exemption allows
parents to deny life-saving medical care to their children on the basis of religious beliefs.
It was the focus of a legislative committee in 2016 and a failed bill in 2017 that would
have allowed court intervention. In spite of the rally and the attention it received, the
legislature again failed to address a child’s right-to-life versus the religious beliefs of
parents.
All the rules and bills proposed by the Board of Nursing easily passed. These included
a bill to eliminate specific degree requirements for Board of Nursing RN positions, rules
to streamline the process for issuing a limited license, and a broadening of requirements
for Advanced Practice Registered Nurse (APRN) faculty and administrators of nursing
education programs.
In May, 2017, Lt. Governor Little issued an executive order directing state departments
and licensing boards to review the necessity of professional and occupational licenses.
The legislature also created an interim committee to review occupational license
requirements in an effort to reduce barriers and determine if licensing is necessary, in
the public interest and non-competitive. The state is interested in hearing from nurses.
You may submit comments to the Board of Nursing or freedomact@lgo.idaho.gov.
Summary of Bills, Rules, and Executive Orders
Bills that passed become effective July 1, 2018. Rules, unless otherwise stated,
become effective immediately upon adjournment of the Legislature.
Board of Nursing Rules – SUPPORTED - Passed
Change in the Process for Issuing Limited Licenses
Under previous rules, nurses suffering from substance use or mental health disorders
surrendered their license to the Board before receiving a limited license. The new rule
allows the Board to convert a regular license to a limited license making the process
more efficient.
Qualifications for Nursing Program Faculty
The new rule broadens the qualifications for APRN faculty, allowing a graduate or
post-graduate degree and national certification appropriate to the area of practice, and
qualifications for non-clinical nursing course faculty requiring preparation appropriate to
the content being taught.
Board of Nursing Bill – SUPPORTED – Passed
S1235 Board of Nursing Educational Requirements– Amends law regarding educational
requirements for RN Board of Nursing Members. Current law requires RN Board
Members to have specific degrees associated with their position on the Board. This has
required board members with an Associate
Degree who then complete a Bachelor’s Degree
to resign their Board position. The change will
eliminate the specific degree requirement for RN Board positions.
Board of Pharmacy Rules - Pharmacist Prescribing Authority – Passed
During the 2017 Session, the Legislature passed H191 which allows the Board of
Pharmacy to determine which drugs and devices pharmacists may prescribe. The law
sets four criteria for prescription authority situations:
1. Does not require a new diagnosis;
2. Are minor and self-limiting;
3. Have a Clinical Laboratory Improvement Amendments of 1988
(CLIA)-waived tests, or
4. Threaten the health or safety of the patient if not treated immediately
Under the rules approved by the legislature, effective July 1, 2018, pharmacists can
prescribe
• Drugs approved by the FDA for
• Lice,
• Cold Sores,
• Motion Sickness Prevention, and
• Uncomplicated Urinary Tract Infections
• Devices:
• Inhalation Spacers,
• Nebulizers,
• Diabetes Blood Sugar Testing Supplies,
• Pen Needles, and
• Syringes
• CLIA-Waived Testing:
• Influenza,
• Group A Strep Pharyngitis
• Drugs approved by the FDA for the purpose of closing a gap in clinical guidelines:
• Statins for patients with a diagnosis of diabetes, and
• Short-acting Beta Agonists (SABA) for patients with asthma who have had a
prior prescription for SABA, and who have a current prescription for a longacting
asthma control medication.
The Board of Pharmacy has been working with the Idaho Medical Association to
create guidelines for prescribing pharmacists.
Executive
Order
Number
Executive
Order
2017-026
Executive
Order
2018-02
Status of Executive Orders and House and Senate Bills
Executive
Order Name
Occupational
Licensing
Restoring
Health
Insurance
Choice
ANA Idaho
& NLI
supported?
Status and Information
Under the review process, the report from each
Executive agency will include:
• The timeframe in which a license is either granted
or denied
• Prerequisites for a license
• Renewal requirements
• Requirements for accepting or denying an
application and license renewal
• Qualifications for suspension, revocation or other
disciplinary action
• The cost to apply for an application or renewal of
a license
• The cost for administering the licensing and
renewal process
The Governor’s proposal is to allow Health Insurers
to provide plans that do not fully cover all 10 essential
benefits required under the Affordable Care Act. The
insurers would be required to continue to offer plans
on the Idaho Healthcare Exchange and at least one
individual plan that do comply with the requirements
of the ACA. The Governor’s executive order does
not require legislative approval. The Governor had
received a letter from CMS indicating that providing
ACA non-compliant plans would violate federal law.
Lt. Governor Little met with CMS to address those
issues. A final determination by CMS is pending.
2018 Idaho Legislature – Session Wrap Up continued on page 9
May is Better Speech and Hearing Month!
Every year in Idaho –
· An estimated 70 babies are born with some degree of hearing loss.
· About 1 in every 10 babies who do not pass the newborn hearing
screen are found to have a hearing loss.
Babies can’t tell us they can’t hear, but hearing
problems can be detected in the first months of life.
The reason to screen is to intervene!
For more information, please call Idaho Sound Beginnings at
(208) 334-0829 or at www.IdahoSoundBeginnings.dhw.idaho.gov

May, June, July 2018 RN Idaho • Page 9
2018 Idaho Legislature – Session Wrap Up continued from page 8
House
Bill
Number
H342
H352
H353
H354
H393
House Bill
Name
Hospitalization
of Criminal
Mentally Ill
– Restore to
Competency –
30-day notice to
10-day notice
Occupational
Licensing
Exemption
for Athletic
and Theatrical
Events
Immunity
for Volunteer
Healthcare
Providers
Opioid Agonists
– Add to
Prescription
Monitoring
Program
Immunization
Assessment
Board
ANA Idaho
& NLI
supported?
Yes
Yes
Yes
Status and Information
Held in Committee, Failed
This bill was an effort by the Department of Health
and Welfare to more quickly move incarcerated
mentally ill patients out of the state hospital once
competency is restored.
Passed
This bill will waive Idaho licensure for physicians,
physician assistants, dietitians and athletic trainers
from other states who come to Idaho for brief periods
to provide medical care during athletic or theatrical
events.
Passed
The proposal provides additional immunity for
physicians, nurses and other healthcare providers
who volunteer for community health screening and
events.
Passed
This bill adds Opioid Agonists such as Narcan to
the Prescription Drug Monitoring Program.
Passed
This bill extends the sunset date for the Immunization
Assessment Board to 2024. The Board provides access
to vaccines for providers throughout the state.
H410 Cannabidiol Oil Failed
The bill would have authorized physicians to
prescribe Cannabidiol for the treatment of seizure
disorders. Idaho currently participates in a federally
supervised study on the use of Cannabidiol that
involves approximately 30 children with seizure
disorders. The chairman of the Senate Health and
Welfare Committee held the bill without a hearing.
H448
H464
Exemption
from Obscenity
Laws for
Breastfeeding
The Idaho
Health Care
Plan
Yes
Yes
Passed
The legislation protects public breastfeeding from
laws covering indecent exposure.
Held in Committee, Failed
An effort to bring H464 out of committee for
a vote to allow Idaho to seek waivers from the
federal government to address health coverage for
those in the Gap failed just before the Legislature
adjourned. Hundreds, including members of
ANA-Idaho and NLI, descended on the capitol to
pressure legislators to take action this year. The
Governor described H464 as the “last best effort
to address healthcare for Idahoans.” Without a last
minute move to vote on H464, the legislature, once
again, failed to address the needs of Idaho families
who cannot afford health coverage.
H465
H494
H495
H505
H615
H634
Medicaid,
Preventive
Dental Care
Immunization
Notice
Health Care
Billing Equity
Act
Physical
Therapist Dry
Needling
Non-ACA
Health Plans
Suicide
Prevention
Training for
Teachers
Yes
Yes
Passed
H465 restores dental coverage that was removed in
2011 for those under the Basic Medicaid program,
approximately 33,000 adults with children who are
below 26% of the federal poverty limit ($4,212/
year for a family of two such as a single mother
and child). Children and those covered under the
Enhanced and Coordinated Medicaid programs
already receive dental services.
Held by Chairman, Failed
This bill would require providers to secure a
signature each time an immunization is given
that would either allow or reject posting the
immunization to IRIS, the state common database
for immunizations. IRIS already allows individuals
and parents to opt-out. This bill extends that optout
for each individual immunization event. The
bill was held by the Committee Chairman and did
not get a hearing.
Held in Committee, Failed
Representative Luker from Boise proposed this
bill to address balance billing practices by nonnetwork
providers who treat patients in a network
facility. For example, when a patient presents with
an emergency to a hospital and is treated by a
physician who is out-of-network, but the hospital
is within the insurance network, this bill would
prevent the out-of-network provider from balance
billing the patient and also provides a formula for
payment similar to in-network rates. The bill was
strongly opposed by the insurance companies and
the medical community.
Passed
Under H505 physical therapists are authorized to
perform dry needling using thin filament needles
to penetrate deep tissue for the relief of pain and
tension. Therapists would need to complete 50
hours of education in addition to other licensure
requirements approved by the Board of Physical
Therapy.
Failed in Committee
The bill would have codified in law the Governor’s
executive order to allow ACA non-compliant
health plans.
Passed
This bill will require two hours of suicide awareness
and prevention training each year for teachers that
would be incorporated into the existing in-service
requirements and could be completed through
self review. Training materials will be provided to
school districts through the Idaho Office of Suicide
Prevention. The law also requires school districts to
adopt suicide prevention policies.
2018 Idaho Legislature - Session Wrap Up continued on page 10
New Clinic and New CEO!
Join Our Team!
Located on the Umatilla Indian Reservation outside of Pendleton, OR
RN (2) • Physician MD/DO
Nutritionist/Dietitian • Community Wellness Director
Excellent Benefit Package! Positive Teamwork Environment!
New work stations for all staff!
For more information contact, HRRecruiter@yellowhawk.org
Main Clinic: 541-966-9830
www.yellowhawk.org

Page 10 • RN Idaho May, June, July 2018
2018 Idaho Legislature - Session Wrap Up continued from page 9
Executive
Order
Number
Executive
Order Name
ANA Idaho
& NLI
supported?
Status and Information
Cindy Galloway, RDN, LD, IBCLC
cgalloway@cdhd.idaho.gov
The newly formed Idaho Breastfeeding Coalition (2018) is a 501c3 entity and provides
breastfeeding resources to the community, including education opportunities. The
mission of the Idaho Breastfeeding Coalition (IBC) is to facilitate a community and
statewide landscape that protects, supports, and promotes breastfeeding as the biological
norm for a healthier Idaho. The Idaho Breastfeeding Coalition was proud to support the
efforts behind passage of House Bill 448, giving protections to breastfeeding mothers
from the indecent exposure statue. Breastfeeding leads to improved health for infants
and mothers who participate. The American Academy of Pediatrics (AAP) states that
breastfeeding has been shown to decrease prevalence of ear infections, gastrointestinal
incidents, obesity, and Type 2 Diabetes in children who were breastfed (2015). There is
also a decreased incidence of breast and ovarian cancers in women who breastfeed their
children compared to women who did not breastfeed (AAP 2011).
The IBC was able to provide the first annual Idaho Breastfeeding Summit in the
summer of 2017 and is pleased to sponsor the upcoming 2nd Annual Idaho Breastfeeding
Summit, Strengthening Partnerships to Benefit Idaho Families, June 28 and 29, 2018 in
Boise, Idaho. Join lactation consultants, nurses, doctors, midwives and dietitians from
around the state at this interactive and lively conference!
To learn more about the coalition and to become a member or to donate to the
coalition, please visit: http://idahobreastfeeding.com/
For conference registration and additional information including sponsorship
opportunities please visit: http://idahobreastfeeding.com/idahobreastfeedingsummit2018/
References
American Academy of Pediatrics (2011). Benefits of breastfeeding for mom. Healthychildren.
org. Retrieved from: https://www.healthychildren.org/English/ages-stages/baby/breastfeeding/
Pages/Benefits-of-Breastfeeding-for-Mom.aspx
American Academy of Pediatrics (2015). Why breastfeed? Healthychildren.org. Retrieved
from: https://www.healthychildren.org/English/ages-stages/baby/breastfeeding/Pages/Why-
Breastfeed.aspx
Idaho Breastfeeding Coalition. (2018). Retrieved from: http://idahobreastfeeding.com/
H638
H657
S1224
S1227
S1262
S1271
Reporting
Complications
of Abortion
Battery against
Health Care
Workers
Medicaid
Expansion
Immunization
Exemption
Form
Patient
Caregiver
Support Act
Health Care
Organization
No
The
Governor
was urged
by ANA-
Idaho and
NLI to veto
H638.
Yes
Yes
Passed
House Bill 638 requires health care providers,
clinics and hospitals to report the complications of
abortions to the Department of Health and Welfare.
Patient identity is protected. The Department will
then prepare an annual report on the complications
of abortions in Idaho for the legislature and the
public. The bill includes a long list of potential
complications. Failure to report would be a
misdemeanor and would be cause for disciplinary
action against the provider’s license. This bill not
only targets providers of abortion but other health
care providers, including nurses and hospitals
whenever a complication of abortion is suspected and
not reported. The bill alters the nurse practice act to
include disciplinary license action for violation.
Held in Committee, Failed
H657 did not get a hearing. It would have amended the
current law that makes it a felony to assault a health
care worker when they are in the course of their duties.
When this law was initially passed in 2014 to protect
health care workers, prosecutors were given discretion
in applying the law to those with mental illness. Since
2014, 209 cases have been prosecuted. Many of those
cases were against individuals suffering from a mental
crisis, some being treated in a mental facility. The
consequences of applying the law to the mentally ill
include jail time and a felony conviction permanently
on their record, making future employment and housing
more difficult. The bill would continue to treat assaults
against health care workers as a felony, but exempts
patients who are seeking admission or are admitted to a
hospital or mental facility for their acute mental illness.
Patients who are intoxicated by alcohol, drugs or other
substances are not excluded from felony prosecution.
Held by Chairman, Failed
This bill would fully expand Medicaid under the
Affordable Care Act (ACA) to cover those in the
Gap between Medicaid qualification and subsidy
eligibility under the ACA. Expansion was a
component of the ACA as originally designed. Idaho
and other states sued the federal government and
won in a U.S. Supreme Court decision that allowed
states to opt out of expanding Medicaid. Under
the plan the federal government would initially
cover 90% of expansion costs but obligates states
to federal intrusion that the Idaho legislature has
resisted. The bill was held by the Chairman of the
Senate H&W Committee.
Held by Chairman, Failed
S1227 clarifies the manner that a parent may exempt
their child from Immunization by allowing any
written notice to the school. This was a contentious
issue last year where school districts required a
specific form for non-immunized students.
Failed
The Patient Caregiver Support Act is a national
initiative by AARP to require hospitals to document
a patient’s selection of a caregiver and notify them
upon the patient’s discharge or transfer. It would also
have required the live instruction of the caregiver on
post-discharge care including medication management,
injections and wound care, tasks that do not require a
licensed professional.
Passed
The definition of Health Care Organization was
broadened to include Residential Care Facilities for
the purpose of peer review privilege.

May, June, July 2018 RN Idaho • Page 11
Elizabeth Montgomery, BS Ed.
Executive Director of the Inland Northwest SIDS/
SUID Foundation, Hospital and Health
Systems Educator - Northwest Region
info@inwsids.org
As the Executive Director of the Inland Northwest SIDS/
SUID (Sudden Infant Death Syndrome/Sudden Unexplained
Infant Death) Foundation in Coeur d’Alene, ID; a
nationally recognized non-profit dedicated to safe infant
sleep education and eliminating preventable sleep-related
accidental deaths, it is my privilege to invite you to become
part of an amazing program sweeping the nation’s hospitals
in response to the American Academy of Pediatrics
recommendations for Safe Infant Sleep released in 2012.
Hospitals are urged to become a National Safe Sleep
Certified Hospital in hopes to reduce infant mortality
due to sudden infant death and of course, to increase their
standard of care. The state of Idaho has a SUID death
rate of 89 deaths/100,000 births. Research shows that
up to 90% of these deaths are accidental due to placing
babies to sleep in unsafe sleeping environments and over
50% of these deaths are a result of bed-sharing.
The Cribs for Kids® National Safe Sleep Hospital
Certification program awards recognition to hospitals
that demonstrate a commitment to reducing infant sleeprelated
deaths by promoting best safe sleep practices and
by educating on infant sleep safety. By becoming certified,
Jenni Blendu, RN, MBA
President Idaho Association for
Home Care and Hospice
jblendu@healthrecoverysolutions.com
(208) 407-1454
Do you work in a primary care setting? If you work
with a physician who provides the essential service
of overseeing and providing guidance to patients on
home health services, new home health conditions of
participation affect you and your practice. You may
notice changes in how offices receive communication
regarding care of home health patients in response to a
new regulation effective January 13, 2018. The new Home
Health Conditions of Participation require:
Ҥ484.60(c)(3)(i) Any revision to the plan of care
due to a change in patient health status must be
communicated to the patient, representative (if any),
caregiver, and all physicians issuing orders for the
HHA [home health agency] plan of care” (Center
for Medicare and Medicaid, 2017, p. 25).
These conditions are a set of Centers for Medicare and
Medicaid Services (CMS) regulatory requirements that all
home health agencies providing CMS-certified home health
services must meet. The goal of the new requirements is to
improve interoperability between care settings.
In order to meet the spirit and letter of this new
regulation, home health agencies across the country will
begin to send “Plan of Care” updates to physicians who
are involved in the patient’s plan of care. The messages
will summarize the changes to the patient’s care so that
each physician is kept up-to-date; the physician will not be
SIDS Foundation
a hospital is demonstrating that it is committed to being a
community leader and is pro-actively eliminating as many
sleep-related deaths as possible.
The certification is of no cost to your hospital including
the required staff training. Cribs for Kids is making it
possible for Inland Northwest SIDS/SUID Foundation to
come to your hospital and support your team through the
certification process. This includes policy creation, staff
training, ordering materials and whatever else you may need.
Inland Northwest SIDS/SUID Foundation would be
honored to be a part of your certification process and to
partner with you to eliminate accidental sleep-related
deaths in Idaho. Please contact me as soon as possible to
begin the process: I am here to support you!
Please visit cribsforkids.org to learn more about the
certification or contact Liz Montgomery info@inwsids.org
or 208-557-4371. For more information on SIDS/SUID and
to get involved visit https://www.inwsids.org/index.html
New Home Health Conditions
of Participation
required to sign or take any other action on the message.
Usability and reducing administrative burden are priorities
for CMS, and the new requirement is intended to provide
significant improvements to collaboration across the
patient’s care team.
If you are interested in learning more about the
regulation, you may find further details within the
Interpretive Guidelines, pages 24-26:
• https://2whl0l41faj52syvna3ew4zl-wpengine.
netdna-ssl.com/wp-content/uploads/2017/10/3819-F.
HomeHealthAgency.CoPs_IGs.pdf
If you have any feedback on the regulation, you may
contact CMS directly:
• Andrew M. Slavitt and Sylvia M. Burwell, Centers
for Medicare & Medicaid Services, 7500 Security
Boulevard, Baltimore, MD 21244
Reference:
Center for Medicare and Medicaid Services (2017). CMS-3819-F
Medicare and Medicaid program: Conditions of participation
for home health agencies interpretive guidelines. Retrieved
from https://2whl0l41faj52syvna3ew4zl-wpengine.
netdna-ssl.com/wp-content/uploads/2017/10/3819-F.
HomeHealthAgency.CoPs_IGs.pdf
Welcome New
Board Member
We have a new Editorial
Board volunteer, Christine
Westrup, BSN. Here is
what she has to say about
herself & the opportunity
to serve on the editorial
board: “I currently work
at St. Luke’s Boise on
6E medical/surgical and
telemetry units. I’m excited
to be able to provide up to
Christine Westrup
date information to Nurses
in Idaho as well as staying informed myself! I hope to
bring light into nursing for our future nurses and to be
able to make powerful changes!” Welcome Christine!
We all have a role to play
in preparing Idaho for the
challenges of responding to
a public health emergency or
natural disaster. Please share
your nursing skills by registering
with the Medical Reserve Corps
in your area. Training is free.
Join us today!
www.volunteeridaho.org
That research paper isn’t going to write itself.
Visit www.nursingALD.com
to gain access to 1200+ issues of official state nurses
publications, all to make your research easier!
$1,000 sign-on bonus
plus
$1,000 relocation bonus
Morrow County Health District has an opening for a FULL-TIME
REGISTERED NURSE for Pioneer Memorial Hospital, a 21-bed Critical
Access Hospital in Heppner, (rural NE) Oregon, a friendly “home town”
community surrounded by great outdoor recreation. New Grads welcome
to apply. Our small hospital provides a wide range of experience in all
areas. Get to know your patients and see your care make a difference.
Must have or obtain Oregon license. Competitive wage, Excellent benefit
package. Come visit and check us out. For more information contact CNO
Terri Brandt-Correia at 541-676-2947. Background check and drug screen
required. Applications/complete job description available at
www.morrowcountyhealthdistrict.org or call 541-676-2949 EEOE
Program for
Recovering Nurses
Addiction Intervention and Recovery Services
for Nursing Professionals
Do you know a nurse or a colleague who needs help for
drugs/alcohol or mental health problems?
Please contact us for assistance. This program is an
alternative to disciplinary action offered by the BON.
For immediate assistance, please call us at 800-386-1695
www.southworthassociates.net

Page 12 • RN Idaho May, June, July 2018
ANA Idaho is pleased to honor deceased registered
nurses who graduated from Idaho nursing programs
and/or served in Idaho during their nursing careers.
Included, when known or when space allows, will be
the date when deceased and the Idaho nursing program.
The names will be submitted to the American Nurses
Association for inclusion in a memoriam held in
conjunction with the ANA House of Delegates. Please
enable the list’s inclusiveness by submitting information
to rnidaho@idahonurses.org.
Brenner Hudlet, Carolyn Joyce, 01/02/2018.
Carolyn was born July 15, 1932 in Buffalo, NY. She
graduated from nursing school in Buffalo and used
her talents in various cities the last one being Coeur
d’Alene. She retired from the Panhandle Health District
in 1995. She loved the outdoors of Northern Idaho. She
will be remembered for her water-skiing and love of
life.
Bushman, Elise, 02/26/2018. Elise graduated
from Chester County Hospital in West Chester, PA.,
and earned her LPN. After moving to Washington,
she earned a BSN and worked in Idaho as a private
duty nurse and earned several nursing awards. She is
known for her love of animals, compassion, caring, and
generosity. Elise will be missed by all whose life she
touched.
Carlos, Karen, 02/13/2018. Karen was born May
20, 1947. She attended Sacred Heart School of Nursing,
graduating in 1967. She loved to travel with family and
friends; the ocean was one of her favorite places.
Fogg, Barbara White, 09/28/2017. Barbara
graduated from the first nursing class at Weber College
in Utah. She earned a BSN from the University of
Utah. She completed missions in Brazil for her church,
was passionate about baseball, and worked at the LDS
hospital in coronary care. In Idaho, Barbara worked in
nursing at Caldwell Memorial Hospital and West Valley
Medical Center for over 34 years. She was endearingly
known as “Mother Fogg” and is remembered as a
caring and compassionate nurse who most loved
serving others. She touched the hearts and lives of
many and will be greatly missed.
Forsman, Mary ‘Esther’ Lincoln, 01/05/2018.
Esther was born on July 29, 1922 in Etty, Kentucky.
She graduated from school in Spaulding, Idaho. She
attended West Baltimore General Hospital School
of Nursing in Maryland as a cadet nurse candidate.
After graduation, she went into the Army Nurse Corp.
During her time, Esther served on the S.S. Stafford
Hospital Ship. She was a first lieutenant during WWII.
Esther worked at various US Army Base Hospitals in
The Philippines and Japan during the US occupation.
When she returned home, she worked with North Idaho
District Health Department as a traveling nurse and
Potlatch Forest Corp. She was active in the community
of Lapwai Idaho and her church. Her hobbies included
needlework, quilting and various outdoor activities.
Halvorson, Rhonda L., 10/15/2017. Rhonda was
a dedicated licensed vocational nurse. She lived in
Garden City, Idaho, and dedicated the majority of her
adult life caring for her special needs son, Brenton.
Rhonda was passionate about camping and quilting/
needle-working. She gifted beautiful homemade quilts
to others. She is lovingly remembered by her family
and friends.
Harp, Dixie Lee, 12/22/2017. Dixie was born in
Banks, Idaho, and completed her nursing degree from
Boise State University. She worked as an LPN in
Boise’s Treasure Valley Manor. She loved the Idaho
mountains, rivers and animals. Dixie is remembered
for her compassionate care and selflessness toward
others. She is missed by her family and lifelong
friends.
Henry, Wanda Lee Kinkead, 03/10/2018. Wanda
Lee studied nursing during WWII and completed her
education to serve as a nurse educator, Registered
Nurse, and nurse practitioner. She worked in Idaho
and Washington until her retirement. She was
involved in various ministries in local churches,
Northwest Nazarene University, and the Work and
Witness trips. She spent much of her time helping to
build hospitals, schools, homes, churches and a well
in Papua New Guinea. Her commitment to nursing,
her family and her concern for the welfare of others
will be greatly missed.
Mankin, Roena ‘Ronnie’ Mannschreck,
02/02/2018. Ronnie was born July 25, 1928 in
Trumbull, Nebraska, the youngest of 8 children.
Graduated from high school in 1945. From there
she attended Hastings College for a year, then
she boarded a bus to Omaha to begin her nursing
training at University of Nebraska. There she meet
a handsome medical student and later married
William Mannschreck in 1951. After graduation from
nursing school, she worked in an ENT clinic. She
then worked as an obstetrical nurse at Presbyterian
Hospital in Chicago. She excelled in her job and
became an assistant head nurse. She then moved to

May, June, July 2018 RN Idaho • Page 13
Denver where she worked as an obstetrical nurse and
had her first child. Upon moving to Lewiston, Ronnie
stopped nursing to raise her family. She took great joy
in her family and is remembered for having a warm
and inviting home. She was active in the Lewiston
community during her life.
Murphy, Mary Beth, 02/1/2018. Mary graduated
with a BSN degree and an Associate of Science
degree in psychology from Idaho State University.
After graduation, Mary worked for Joshua D. Smith
in Psychosocial Rehabilitation and in the fall of 2002,
she joined Portneuf Medical Center’s, Behavioral
Health Services, in Pocatello, Idaho, where she
became a pioneer and innovator in psychiatric
nursing. She quickly became a leader in the delivery
of nursing care, bringing her own style of stimulating
patient engagement and motivating changes in
behavior. Mary delivered her care to patients with
great compassion, strength, and dignity. Discharged
patients would often call the unit to speak to Mary
for continued support and to report their progress.
Mary received many accolades from patients and the
Portneuf Medical Center, including the Employee of
the Quarter award, the 2009 March of Dimes Idaho
Nursing Excellence Award, the Portneuf WIN award
for Service Excellence, and the prestigious DAISY
Award for Extraordinary Nurses who go above and
beyond the call of duty. Mary had to step down from
nursing in 2017 for health reasons. She continued her
love for fishing, camping, canning, and her backyard
chickens. She will be greatly missed by her family,
colleagues, and her patients.
Nitz, Betty Jane, 01/26/18. Betty was a well-known
and loved resident of Elk City, Idaho. She was born
November 8, 1935. She attended Elk City High School
thru the 10th grade and later received her high school
completion via correspondence through American
School of Nebraska. She married Wayne Nitz in 1951
and had 3 children. Betty trained to be a Practical Nurse
at Grangeville General Hospital and was an emergency
room nurse for 19 years. She worked with Drs. Soltman,
Morrison and Cone. “Her services were free except
when she had to give a shot for $2.” Betty enjoyed many
outdoor activities including snowshoeing, snowmobile
racing and flying a small Cessna.
Peterson, Lorene Fife, 12/17/2017. Lorene was
born March 31, 1924 at Gritman Hospital located
in Moscow, Idaho. Upon graduation from Moscow
High School in 1942, she moved to Portland,
Oregon to attend Emanuel Hospital Nursing School.
She received a Registered Nursing Degree. After
completion, she served at Sawtelle Veterans Hospital
in Los Angles during the final years of WWII. She
married James Fife and raised two sons.
Powel, Katherine ‘Katie’, 12/30/2017. Katie
was born on 12/16, 1923 in Washington. She
attended nursing school at Sacred Heart in Spokane,
Washington. She graduated with registered nursing
degree. She initially worked at St. Ignatius Hospital
in Colfax, Washington. Upon marriage in 1946 she
took time to raise her family and manage their home.
Katie did some private duty nursing over the years
for people she knew, however, her focus was her
family. She was an excellent cook and known for
her ‘delicious home-baked pies.’ “Good friends and
good fun” were a common theme throughout Katie’s
life.
Rust Mauser, Sally, 02/10/2018. She graduated
from Coeur d’Alene High School and Deaconess
School of Nursing in 1956. She married Bruce
Mauser and had 2 children. She lived in Spokane
and practiced nursing in the Inland Northwest. She
later moved to Seattle, Washington and retired from
University of Washington Hospital. She will be
remembered as an incredible wife, mother, friend,
nurse, and counselor as well as her artistic abilities.
Salyer, Nancy C., 01/15/2018. Nancy earned
a diploma in nursing from Providence Hospital
in Detroit, Michigan, and then later completed a
bachelor’s degree in business administration from
the University of Detroit and a Master’s of Science
in Health Administration from the University
of Michigan. Within Idaho, she served as Vice-
President of Patient Care Services for Mercy
Hospital in Nampa and as Administrator for Surgical
Services at St. Luke’s Regional Medical Center in
Boise. She was proud of her leadership of the team
that worked to successfully obtain Magnet status
for the medical center. Nancy is also remembered
for her kindness, compassion, generosity, and
great concern for others. She tirelessly worked
to provide exceptional patient care with a teamapproach.
Her zest for life, her laugh, and spirit of
adventure brought joy and smiles to others. Her life
is celebrated by family, her dog-friend, colleagues,
and patients.
Steinhaus, Priscilla, 02/17/2018. Priscilla
completed her nurses’ training at Northwest
Nazarene College in Nampa, Idaho. She worked at
the Samaritan Hospital in Nampa and at the Caldwell
Hospital in Caldwell, Idaho. Priscilla was a dedicated
and much-loved volunteer at the Care House, a food
bank run by her church. She is remembered for
her love of family, enjoyment from her extensive
recreational vehicle (RV) travels, and dedication to
others. She will be forever missed.
Toothaker, Anne W., 01/04/2018. Anne was
born in Ohio, worked in Cleveland, Ohio, and later
moved to Boise. She worked as a nurse in a variety
of areas including psychiatry and intensive care units.
She volunteered her time to organizations such as
Planned Parenthood, the Women’s and Children’s
Alliance, and Refugees of Boise. She ran The Race
to Robie Creek multiple times, was a life-long
member of the YMCA, and enjoyed Boise’s literary
arts organization, the Cabin. She is remembered for
her unique spirit, civility, kindness to everyone, and
saying, “Because you never know what someone
else’s day is like.” Anne enjoyed the outdoors and
taking extended motorcycle road trips with her
husband. Her energy and generosity of spirit will be
greatly missed.
Widmyer, Mary, 02/11/2018. Mary was born
April 21, 1940; she married Duane Widmyer in 1958
and had two children. She moved to Coeur d’Alene
in 1963 and was a homemaker. In the 1970,’s Mary
attended North Idaho College and graduated with
Practical Nursing degree. Mary enjoyed singing and
spending time in her flower garden and with family.
She will be remembered for her sense of humor.
Wingett, Rosalie, 03/06/2018. Rosalie of Emmett,
Idaho, completed her nurses training in Portland,
Oregon, and worked in facilities across Portland
and Eugene. She worked in Boise as a charge nurse
at Sunset Nursing Home. She engaged in a second
career as a co-business owner and then worked and
managed with her husband a 25-acre fruit orchard
in Emmett. She is remembered for her hard work,
adventuresome spirit, adventures in traveling, and for
her laughter. She is greatly missed by her family, the
center of her life.
Not sure
where to
start?
Visit PubMed for Nurses,
https://www.nlm.nih.gov/
bsd/disted/nurses/cover.html
short videos designed
to introduce nurses to
searching PubMed.
For further assistance
contact Patricia Devine
at Devine@uw.edu
Pacific Northwest Region

Page 14 • RN Idaho May, June, July 2018
Evidence-Based Screening Practices
for Postpartum Depression
Sydney Parker, BSN, RN
separker@lcsc.edu
Postpartum depression (PPD) is a mental health
condition that impacts postpartum women of all ages,
socioeconomic status, race, and backgrounds (Yawn et al.,
2012; National Institute of Mental Health, 2018). Though
there are many risk factors that increase the chance for
women to experience PPD, there is no one method to
prevent or predict who may experience it. Over 15% of
women report PPD in their first-year postpartum, and the
American College of Obstetricians and Gynecologists
(ACOG) estimates 5-25% of postpartum women
experience PPD (2015; Yawn et al., 2012). This would
be roughly more than 10,000 postpartum women in
the United States each year. Meanwhile, over 50% of
women that experience severe depressive symptoms go
unnoticed (Yawn et al., 2012). According to National
Institutes of Mental Health (2018), there are numerous
adverse maternal and newborn outcomes for undiagnosed
or untreated PPD. A simple, evidence-based screening
tool coupled with effective education could help to
significantly reduce the number of undiagnosed/untreated
women. Proper screening lending toward appropriate
diagnosis and treatment may greatly decrease adverse
effects and improve patient outcomes for both women and
their children.
Problem
Many barriers to screening for PPD exist. PPD is
highly stigmatized and many women are uncomfortable
discussing or cannot identify symptoms of PPD (Byatt et
al., 2013). Over 20% of women with PPD do not report
symptoms. Additionally, while there are validated,
evidence-based practice (EBP) screening tools for PPD,
there is no universal standard in the United States for
the use of such tools (Newland & Parade, 2016). This
includes a lack of standard for: type of screening tool to
use, when is the optimal time to screen postpartum, and
where is the best location to conduct such screenings. Due
to the lack of standardization in PPD screening, there
is low physician use of a PPD tool and lack of education
regarding PPD screenings. This perpetuates the cycle of
decreased recognition and decreased treatment, opening
a gap to poor maternal and newborn outcomes (Goldin-
Evans et al., 2012). Up to 95-99% of children attend wellbaby
care visits (WCV), such as at family practice (FP)
September 13
September 13
September 14-15
Fall 2018
Fall 2018
Join us in Boise!
Register Today
Improving the way clinicians diagnose, treat,
manage, and educate their patients.
Clinical STD Update
with Optional Clinical Practicum
August 9, 2018
Boise, ID
CNE/CME Available
For more information:
206-685-9850 • uwptc.org • uwptc@uw.edu
REGISTER NOW
for 2018 Activities!
Workshop on Trauma Informed Care
at the Riverside Hotel in Boise, Idaho
Celebrate Nursing Dinner at the
Riverside Hotel in Boise, Idaho
LEAP Conference at the Riverside
Hotel in Boise, Idaho
Keynote Speaker: Alex Wubbels, BSN, RN
Introduction to Leadership 3-Day
Course - Boise
Advanced Leadership Concepts
Course TBD
Visit www.nurseleaders.org to register!
Contact Karin Iuliano at kiuliano@nurseleaders.org
with any questions or if you need assistance.
or pediatrician offices, as well as follow-up postpartum
appointments at obstetrician (OB) offices, making these
optimal places to conduct screenings for PPD (Goldin-
Evans et al., 2012). Therefore, the question remains: Does
the use of a standardized evidence-based protocol for
screening for postpartum depression (PPD) increase the
number of mothers screened for and diagnosed with PPD
when utilized at well child visits (WCV) and obstetric
(OB) appointments during the first year postpartum?
Current Screening Practices
Currently in the United States, a universal standard
for screening for PPD has not been established. While
the American Academy of Pediatrics (AAP) currently
recommends universal screening in the early postpartum
period at WCV, OB appointments, home visits and
community outreach centers, it does not specify a
timeframe for screening or recommend a standardized tool
(Newland & Parade, 2016). ACOG (2015) recommends
at least one screening in the perinatal period using
a validated screening tool, but does not provide a
recommended timeframe for screening. ACOG (2015) also
suggests the importance of more frequent “monitoring” of
women with a history of anxiety or depression but does
not provide a timeframe or evaluation recommendation. In
an effort to increase screening practices, some states have
tied reimbursement for physicians and practitioners to the
completion of PPD screenings (Newland & Parade, 2016).
Screening at Well Child Visits
Van der Zee-van den Berg et al. (2015) completed
a systematic review to determine if screening for PPD
at WCV improves maternal and child outcomes. They
found significant improvement in detection, referral, and
treatment of PPD through screening at WCV using the
Edinburgh Postnatal Depression Scale (EPDS). Yawn et
al. (2012) also performed a systematic review to determine
if universal screening for PPD improved maternal and
newborn outcomes. Women were screened using either
the EPDS, Patient Health Questionnaire-9 (PHQ-9), or the
PHQ-2 (a modified version of the PHQ-9) at OB, WCV,
and community outreach programs. The results indicated
that at least two-thirds of the women were screened for
PPD when seen at WCV or OB appointments, suggesting
WCV as a feasible and reliable site for conducting PPD
screenings (Yawn et al., 2012).
Validated Screening Tools
It is relevant to discuss what screening tools are
evidence-based, or validated, for use in identifying PPD.
Hanusa et al. (2008) recommends the EPDS as the most
accurate screening tool. However, Gjerdingen et al. (2009)
found in their study that the PHQ-2 was highly sensitive
(100% predictive of PPD for initial screen) and that the
PHQ-9 was highly specific (92-94% correct in identifying
PPD), suggesting they would be good diagnostic tools.
Based on the literature presented above, all are valid
tools for use in accurate and efficient PPD screening. In
reviewing these tools, it is clear, based on time required
to complete a screening, the increased sensitivity and
specificity of the tools, that the EPDS and PHQ-9
are the most recommended tools for PPD screening.
ACOG (2015) presented all of the validated screening
tools available for physician or provider use in a table
format that may be helpful to providers in selecting the
appropriate tool for their practice.
Competence with Screening
An additional piece to consider when discussing
screening mothers at WCV and OB appointments is
provider competence and comfort with initiating the
screening. Byatt et al. (2013) found in a study of 90
postpartum women that mothers felt concerned about the
inability of providers to discuss, assess and refer them for
PPD. Additionally, Chadha-Hooks et al. (2010) found in a
survey of providers and residents that most clinicians were
unfamiliar with the validated screening tools for PPD,
such as the EPDS. The authors additionally identified that
OB providers were more familiar with the EPDS than
pediatricians, suggesting that the use of this tool to screen
at WCV would require further physician education. In fact,
Goldin-Evans et al. (2012) review of screening practices
found that only 55% of physicians screened for PPD, and
that of those, only 25% used an evidence-based screening
tool when assessing postpartum mothers. Note that these
studies are six or more years old and thus current practice
may be improved.
Conclusions
Based on the literature, several conclusions can
be drawn on which to make recommendations for
standardized screening practices for PPD. First, it
is evident that initiating screening at WCV and OB
appointments increases the percentage of screenings
preformed for PPD, making these ideal locations in
which to conduct screenings and implement universal
screening recommendations. While there are many
validated screening tools for screening for PPD, the
literature illustrates that the PHQ-9 and EPDS are the
most reliable and recommended screening tools. Finally,
Evidence-Based Screening continued on page 15

May, June, July 2018 RN Idaho • Page 15
Evidence-Based Screening continued from page 14
a lack of education and training on screening for PPD
by pediatricians was clear in earlier studies (2010-2012);
both providers and patients report the need for further
education on PPD screening at WCV.
It is important for clinicians to understand the barriers
to screening for PPD. The literature presented indicates
the lack of a universal screening recommendation
for PPD and demonstrates the need for physicians/
healthcare providers to have improved education in
order to successfully screen and appropriately engage
in conversations regarding PPD. It is also evident that
women fear both the stigma associated with PPD and
the lack of physician engagement and ability to screen/
discuss PPD which ultimately deters them from seeking
help when they suspect symptoms. While identification
through screening is a crucial first step, referral sites and
treatment options must also be considered in order to
successfully manage PPD. A lack of consistent follow-up
for postpartum appointments or WCV is a sizable barrier
with implications for future discussion.
American Nurses Association/ ANA Idaho
Membership – It’s Your Choice!
It’s Your Privilege!
Just Because You Received This Publication,
Doesn’t Mean You Are an ANA Idaho Member
Significance to Nursing
Nurses are the backbone to healthcare: their thorough
assessments and patient education, advocacy for patients,
leadership abilities, and role as change agents in the
utilization and implementation of EBP make them key
players in a rapidly changing industry (Yoost & Crawford,
2016). From their work in clinics, schools, and public
health to acute care and academic settings, nurses are the
frontline in managing patient care. As such, this issue is
significant to nurses engaged in assessing and educating
postpartum patients in outpatient OB, FP, and WCV visits.
The ability to initiate screening tools for PPD, recognize
signs and symptoms, educate patients and physicians on
PPD, and report findings to physicians are all essential in
the early and timely detection and treatment of PPD.
Goal:
Increased screening + improved competency and
education + decreased barriers = Increased recognition
and referral for PPD to improve maternal
and newborn outcomes
References
American College of Obstetricians and Gynecologists (2015).
Screening for perinatal depression. Retrieved from https//m.
acog.org/Clinical-Guidance-and-Publications/Committee-
Opinions/Committee-on-Obstetric-Practice/Screening-for-
Perinatal-Depression?IsMobileSet=true
Byatt, N., Biebel, K., Friedman, L., Debordes-Jackson, G., &
Ziedonis, D. (2013). Women’s perspectives on postpartum
depression screening in pediatric settings: a preliminary
study. Archives of Women’s Mental Health, 16(5), 429-432.
Chadha-Hooks, P. L., Hui Park, J., Hilty, D. M., & Seritan, A.
L. (2010). Postpartum depression: an original survey of
screening practices within a healthcare system. Journal of
Psychosomatic Obstetrics & Gynecology, 31(3), 199-205.
Gjerdingen, D., Crow, S., McGovern, P., Miner, M., & Center, B.
(2009). Postpartum depression screening at well-child visits:
Validity of a 2-question screen and the PHQ-9. Annals of
Family Medicine, 7(1), 63-70.
Goldin-Evans, M., Phillipi, S., & Gee, R. (2012). Examining the
screening practices of physicians for postpartum depression:
Implications for improving health outcomes. Women’s Health
Issues, 25(6), 703-710.
Hanusa, B., Scholle, S., Haskett, R., Spadaro, K., & Wisner, K.
(2008). Screening for depression in the postpartum period:
a comparison of three instruments. Journal of Women’s
Health, 17(4), 585-596. doi:10.1089/jwh.2006.0248
National Institute of Mental Health (2018). Postpartum
depression facts. Retrieved from https://www.nimh.nih.gov/
health/publications/postpartum-depression-facts/index.shtml
Newland, R. P., & Parade, S. H. (2016). Screening and treatment
of postpartum depression: Impact on children and families.
Brown University Child & Adolescent Behavior Letter, 32(1),
1-6.
Postpartum Support International (PSI). (2018). PSI Awareness
Poster. Retrieved from: http://www.postpartum.net/resources/
psi-awareness-poster/
van der Zee-van den Berg, A. I., Boere-Boonekamp, M.,
IJzerman, M., Haasnoot-Smallegange, R., & Reijneveld, S.
(2017). Screening for postpartum depression in well-baby
care settings: A systematic review. Maternal and Child
Health Journal, 21(1), 9-20.
Yawn, B., Olson, A., Bertram, S., Pace, W., Wollan, P., &
Dietrich, J. (2012). Postpartum depression: Screening,
diagnosis, and management programs 2000 through 2010.
Depression Research and Treatment, 2012.
Yoost, B.L. and Crawford, L.R. (2016). Fundamentals of
nursing. St. Louis, MO: Mosby/Elsevier.