Utah Nurse - August 2018

The Official Publication of the Utah Nurses Association
Many Roles. One Profession.
UTAH NURSE
Volume 27 • Number 3
August, September, October 2018
Inside
Quarterly publication direct mailed to approximately 33,000 RNs and LPNs in Utah.
UNA's New
Executive Director
Liz Close, PhD, RN
Page 6
The Nursing
Now campaign
launches
Page 11
www.utnurse.org
Check the UNA Website After August 1st
Detailed Agendas & Registration Information
The Utah Nurses Association Annual Education and Advocacy
Conference is Thursday & Friday, September 27th & 28th, 2018 at the
SLCC Miller Conference Center, 9750 S 300 W, Sandy, UT 84070
Legislators, in addition to healthcare policy experts, clinicians, researchers
and educators attend to speak, teach and advise regarding healthcare issues
of vital concern to nurses in Utah and across the nation. This is your opportunity
to be inspired, to learn about innovations in nursing and make your
mark on your world with your influence.
Advocacy Day is September 27th!
Come and prepare yourself to be a stronger advocate for your patients and for your community.
www.utnurse.org
The Utah Nurses Association
Mission Statement:
The mission of the UNA is to advocate, educate,
and be a voice for all nurses in Utah both individually
and as a whole by promoting and facilitating the roles
and functions of nurses in all areas of employment
and in all aspects of professional practice.
Attention UNA Members
You can now find us on Facebook. Just
search Utah Nurses Association and look
for the page with the UNA logo. We will be
posting updates for upcoming events and
information on conventions in our blog.
This year’s Advocacy Day will address substance
abuse, a major health issue in our state. Utah leads
the country in deaths from overdoses and we, as
nurses, need to learn how we can fight this growing
epidemic. Advocacy Day will open with presentations
by clinical content experts on best practices in
addressing acute pain, chronic pain and the reality of
overdoses. Speakers will join for a panel discussion
exploring where nurses fit into the equation. Once we
know the facts we can educate and act responsibly.
The day will start with providing the opportunity
to try new skills such as developing a position
statement, articulating an elevator speech, writing
to legislators and techniques for testifying on issues
before the legislature or government departments.
The afternoon schedule will include a Policy Café
in which participants will examine current issues in
detail and learn techniques of advocacy.
What DO you do when you hear there is a
public comment open for YOUR input?
Come to Advocacy Day. Build your
advocacy skills.
We look forward to working with you.
current resident or
Presort Standard
US Postage
PAID
Permit #14
Princeton, MN
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Content
3 From the Editor
3 From the Membership Committee
4 Announcing the 2018 CDC
Childhood Immunization Champion
Award for Utah
5 "Musing of Caring" Self-Reflective
Moments by Nurses
6 Introducing...Liz Close, PhD, RN
7 ANA Announces National
Awards Recipients
8 Career Sphere
9 Fall Prevention Resources
10 GRC Committee Reports
11 The Nursing Now
campaign launches
11 Nurses on the National Front
12 Patient violence:
It's not all in a day's work
14 Opportunity to Improve HIV
Care in Utah

Utah Nurse • Page 2 August, September, October 2018
PUBLICATION
The Utah Nurse Publication Schedule for 2018
Issue
Material Due to UNA Office
November, December September 6, 2018
January 2019
Guidelines for Article Development
The UNA welcomes articles for publication. There is
no payment for articles published in the Utah Nurse.
1. Articles should be Microsoft Word using a 12 point
font.
2. Article length should not exceed five (5) pages
8 x 11
3. All references should be cited at the end of the
article.
4. Articles (if possible) should be submitted
electronically.
Submissions should be sent to: editor@utnurse.org or
Attn: Editorial Committee | Utah Nurses Association
4505 S. Wasatch Blvd., Suite 330B
Salt Lake City, UT 84124 | Phone: 801-272-4510
Become a Nurse
Peer Reviewer
Looking for a flexible schedule volunteer opportunity
to serve your nursing association and your nursing
community?
Become a Nurse Peer Reviewer — Supporting
Quality Continuing Education
The Western Multi-State Division (WMSD) and its
four member associations — AzNA, CNA, INA, and
UNA invite qualified nurses to serve as peer reviewers
to evaluate continuing education programs for approval.
Their expertise supports continuing education activities
for the nurses in our four state division and beyond.
The WMSD Accredited Approver Unit will provide
training to all qualified Nurse Peer Reviewers to educate
them on the ANCC/WMSD accreditation criteria.
Are you:
• A currently licensed RN with a Bachelors Degree in
Nursing or higher?
• Interested in joining a unique group of nurse peers
supporting providing ANCC accredited continuing
education for the nurses in your community?
• A nurse planner for education programs and events
or a primary nurse planner of an Approved Provider
unit who wants to stay current in your knowledge
of ANCC accreditation criteria?
• Willing to serve on the volunteer review panel or as
an independent reviewer?
• Qualified with a background in education, training,
and or relevant knowledge and experience in
educating nurses that would prepare you to
participate in the peer review process?
• Proficient in Microsoft Office suite, and accessing
email and email attachments?
If so, learn more about the selection and training
process at utnurse.org/education under the Nurse Peer
Reviewers tab.
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the Web at www.xmission.com or call 801-539-
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Please visit the Utah Nurses
Association’s Web Page!
utnurse.org
Visit our site regularly for the most current updates
and information on UNA activities. You can
obtain a listing of Continuing Education Modules
available through UNA or a listing of seminars and
conferences that offer CE credits.
Get credit for your
education efforts!
There are as many aspects to
nursing practice as there are settings
and types of nursing practice.
The “needs” that are identified
for professional development and
practice enhancement will
be as varied.
Don’t assume you can’t offer CE –
Utah Nurses Association can help.
• Contact education@westernmsd.
org with questions.
• Visit www.utnurse.org/Education
to view FAQs and application
information.
CRISIS INFORMATION
If someone you know is in a life
threatening emergency or in
immediate danger of harming
themselves, please call 911.
IF YOU OR SOMEONE YOU
KNOW IS HAVING SUICIDAL
THOUGHTS OR FEELINGS CALL
1-800-273-8255 (TALK)
2018 BOARD OF DIRECTORS
President
First Vice President
Second Vice President
Secretary
Treasurer
Directors
STAFF MEMBERS
Aimee McLean, BSN, RN, CCHP
Donner Schweitzer, BSN, RN
Claire LeAnn Schupbach,
BSN, RN, CPC, CHP
Heather Lowe, BSN, BS, RN
Tracy Schaffer, MSN, RN
Sharon K. Dingman, DNP, RN
Blaine Winters, DNP, ACNP-BC
Jason M. Martinez, BSN, RN
Executive Director
Liz Close, PhD, RN
Editor Claire LeAnn Schupbach, BSN, RN, CPC, CHP
COMMITTEE
CHAIRS & LIAISONS
By-Laws Open - If interested please email resume to UNA
Finance
Tracy Schaffer, MSN, RN
Government Relations
CJ Ewell, MS, APRN-BC
Diane Forster Burke, MS, RN
Kathleen Kaufman, MS, RN,
Membership
Sharon K. Dingman, DNP, RN
Nominating
Janelle Macintosh, PhD, RN
Education Committee Blaine Winters, DNP, ACNP-BC
UTAH NURSES FOUNDATION
President
Marianne Craven, PhD, RN
ANA MEMBERSHIP
ASSEMBLY REPRESENTATIVES
Aimee McLean, BSN, RN, CCHP
Barbara Wilson, PhD, RNC
PRODUCTION
Publisher
Arthur L. Davis Publishing Agency, Inc.
Editor and Publisher are not responsible nor liable for editorial
or news content.
Utah Nurse is published four times a year, February, May,
August, November, for the Utah Nurses Association, a
constituent member of the American Nurses Association. Utah
Nurse provides a forum for members to express their opinions.
Views expressed are the responsibility of the authors and are
not necessarily those of the members of the UNA.
Articles and letters for publication are welcomed by the
editorial committee. UNA Editorial Committee reserves the
right to accept of reject articles, advertisements, editorials, and
letters for the Utah Nurse. The editorial committee reserves
the right to edit articles, editorials, and letters.
Address editorial comments and inquiries to the following
address:
Utah Nurses Association, Attn: Editorial Committee
4505 S. Wasatch Blvd., Suite 330B
Salt Lake City, UT 84124
una@xmission.com, 801-272-4510
No parts of this publication may be reproduced without
permission.
Subscription to Utah Nurse is included with membership to
the Utah Nurses Association. Complementary copies are sent
to all registered nurses in Utah. Subscriptions available to nonnurse
or nurses outside Utah for $25. Circulation 33,000.
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reserve the right to reject any advertisement. Responsibility for
errors in advertising is limited to corrections in the next issue
or refund of price of advertisement.
Acceptance of advertising does not imply endorsement
or approval by the Utah Nurses Association 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. UNA 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 UNA or those
of the national or local associations.

August, September, October 2018 Utah Nurse • Page 3
FROM THE EDITOR
Claire L. Schupbach, BSN, RN, CPC, CHP
August, September and October are a favorite time
of year for me, as the fruits of my labors in the garden
are realized. There is something exhilarating and ‘spiritlifting’
about tangible results from hard work, nurturing
and patience. We, as a nursing community in Utah
have much to celebrate as years of day-in and day-out
commitment and perseverance have been noted and
awarded to part of our family. The ANA 2018 Staff Nurse
Patient Advocacy Award National award was given to
Alex Wubbels, BSN, RN. The 2018 CDC Immunization
Champion Award for Utah was presented to Judy
Yaworsky, BSN, RN, NCSN. Liz Close, PhD, RN, newer
to the Utah family of nursing, is now gifting the UNA with
her lifetime wisdom, fresh energy and knowledge as the
Executive Director.
The dedication, time, willingness to speak openly by
each state’s ANA representatives, have resulted in new
national leadership for our organization, support for
addressing the opioid crisis and guidance on our role for
aid in dying. Building towards the future internationally,
the Nursing Now Campaign has kicked off coordinated
to last until 2020, Florence Nightingale’s 200th
birthday celebration. This aligns with the national Nurses
on Boards Coalition initiative, as the overarching goal is
to increase nurses’ influence on health policy and in all
levels of leadership. Again, the truth of the impact of
collaboration in moving forward presents itself with clarity.
Gratitude and appreciation for all of you who have
continually worked, nurtured and gifted the Utah Nurse with
information, articles, and heart-felt transparency into your
nursing practice over the years. The fruits of those labors
have been rewarded with the Utah Nurse’s inclusion in the
CINAHL database.
Looking forward to September 27th & 28th, we
are excited to present to the Utah nursing community
the UNA’s Annual Education and Advocacy Conference.
Please check the UNA website (www.utnurse.org) for
detailed agenda and registration information after August
1st or email request for
information to office@utnurse.
org. We hope you join us for
this Utah focused opportunity
to change our world for Utah
patients. The sacrifices of
time and energy by the UNA
Conference Committee to
produce this event are given
with a heart towards service
and driving collaboration
across the nursing and Claire L. Schupbach
legislative community in Utah.
We stand on the shoulders of those who have gone
before us and the future will stand on our shoulders.
Be encouraged and energized as you read this Utah
Nurse of the imprint that we are making for the future.
As is fitting with the ‘harvest’ cycle in nature, this edition
celebrates the ‘harvest’ of our nursing community, here in
Utah and across the world.
FROM THE MEMBERSHIP
COMMITTEE
Sharon K. Dingman, DNP, MS, RN
UNA Director at Large &
Membership Committee Chair
The Utah Nurses
Association (UNA) Board
and Membership Committee
will be considering
recommendations made by
the members of the American
Nurses Association (ANA)
Membership Assembly held
in Washington DC during
the third week of June 2018.
The overall aspirational goal
for ANA Enterprise/UNA is
to “Transform health and
healthcare by ensuring nursing
excellence. The expertise,
knowledge and wisdom of
Sharon K. Dingman,
DNP, MS, RN
nurses are essential to advancing health and health care
for all” (ANA Enterprise, 2018). UNA plans to align their
goals with those of ANA by creating value for membership,
nurse engagement, and tools for nurses to succeed, foster
work environments to support nursing excellence and
health, position nurses as influential leaders and experts,
and advance nurse-lead innovation to improve healthcare.
Congratulations to all new members in 2017
that raised membership by 21% increase from 500
members to 605 members. This initiative of “Be a
Member, Bring a Member” began in 2017 and continues
to be a focus for 2018. The UNA Website update began
in 2017 to meet the ANA/UNA online technical capacity
for membership information and will continue into 2018
with assistance of additional technical support for the
website membership section. Other achievements and
recommendations will be shared in the UNA Annual
Report and subsequent editions of the Utah Nurse.
UNA has hired an Executive Director to support the UNA
Board and assist with business affairs of the organization.
At the time of production for this edition of the Utah
Nurse, the results of the ANA Membership Assembly
were not available for review by the UNA Board and
recommendations for the 2018-19 UNA Membership at
large. UNA members will receive the recommendations
and updates at the UNA Annual Fall Conference
scheduled for September 27th & 28th, 2018, subsequent
Utah Nurse Editions and on the UNA Website.
Please take a few minutes to review the current
benefits of ANA/UNA Membership information online:
Membership information is found in the ANA Member
Guide Information folder [(©AHA, 2014 ANA-BRO6
(6/16)]. We encourage you to renew your membership at:
http://www.nursingworld.org/joinana.aspx
Benefits for ANA/UNA members includes access to
professional tools you will use in your professional life,
including access to research tools, nursing resources,
etc. You can access these resources through your
MyANA account at NursingWorld.org/MyANA.
Being a member of ANA/UNA makes a powerful
statement about you and your commitment to nursing.
Membership provides a way for nurses across the
United States and Utah to speak with one strong voice
on behalf of nursing and our patients. Continuing
education and member programs provide you access to
learning opportunities to keep you up-to-date in nursing
knowledge and advance your career. Additionally, you will
find information about personal health and healthy work
environments that are safe, empowering, and satisfying.
As a member, you can stay up-to-date through
journals and publications: American Nurse Today
(monthly journal); The American Nurse: ANA’s official
newspaper, The Online Journal of Issues in Nursing
(OJIN) by using your member login at NursingWorld.
org/OJIN, E-Newsletters: ANA SmartBrief, ANA Nurse
CareerBrief, Nursing Insider, and Member News.
Network and connect through social media with
your state and national association by visiting the UNA
website http://www.utnurse.org. For additional local
information contact us at una@xmission.com or send
correspondence to Utah Nurses Association, 4505 S.
Wasatch Blvd., Suite 330B, Salt Lake City, UT 84124 to
the attention of UNA Membership Committee Chair/
Executive Director.
IMPORTANT CONTACTS AT-A-GLANCE
ANA Member Services:
1-800-923-7709
FAX: 1-301-628-5355
Mail: American Nurses Association
8515 Georgia Avenue, Suite 400
Silver Spring, MD 20910
Update Your Profile:
NursingWorld.org/MyANA
ANA E-mail Addresses:
• Membership: memberinfo@ana.org
• American Nurses Foundation (ANF): anf@ana.org
• ANA-PAC: ana-pac@ana.org
• NursesBooks.org: anp@ana.org
• Ethics Issues: ethics@ana.org
• Lobbying — Federal and State: gova@ana.org
• Meetings and Conferences: meetings@ana.org
Look up your state nurses association’s contact
Information by going to NursingWorld.org
Professional Development and Networking
Resources Online:
• ANA Career Center: NursesCareerCenter.org
• ANA Leadership Institute:
ANA-LeadershipInstitute.org
• ANCC Certifications: NurseCredentialing.org
• Book Discounts: NursesBooks.org
• Online Continuing Education: ANANurseCE.org
• Navigate Nursing: NavigateNursing.org
American Nurses Credentialing Center:
1-800-284-CERT (2378)
Health Facility Surveyors
The State of Utah, Department of Health, Division of Family
Health Preparedness, Bureau of Health Facility Licensing and
Certification is recruiting for Registered Nurses to work as
Health Facility Surveyors in the Long Term Care Survey Section.
Working four, ten hour days, with weekends and holidays off, you will be part
of a team of quality conscious health professionals conducting unannounced
surveys of Medicare and Medicaid certified nursing homes. As you travel the
beautiful State of Utah, you will use your clinical experience and education
to ensure nursing homes comply with federal regulations. You will have an
opportunity to make a positive influence to the lives of individuals residing in
Utah’s nursing homes. To be considered, you must possess a current Utah
license as a Registered Nurse, without restrictions.
For questions regarding the Health Facility Surveyor positions or duties,
you may contact Greg Bateman by email at gbateman@utah.gov.
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Utah Nurse • Page 4 August, September, October 2018
The CDC Childhood
Immunization Champion
Award is an annual award
given jointly by the CDC
Foundation and CDC that
recognizes individuals
who make a significant
contribution toward improving
public health through
their work in childhood
immunizations. Each year,
up to one CDC Immunization
Champion from each of
the 50 U.S. States, eight
U.S. Territories and Freely
Announcing the 2018 CDC Childhood
Immunization Champion Award for Utah
Judi Yaworsky,
BSN, RN, NCSN
Association States, and the District of Columbia will be
honored.
The Utah Department of Health is proud to announce
that Judi Yaworsky, BSN, RN, NCSN, a school nurse
from Salt Lake School district has won this award for
2018. She has been an immunization champion for
several years and utilizes her leadership within the Utah
School Nurses Association to promote vaccines in
both preschool and school age children. She actively
participates in the Greater Salt Lake Immunization
Coalition and supports community strategies for
improving immunization rates in infants and in children.
Judi feels passionate about protecting the health and
lives of children. She wants each child to have the
opportunity of being protected, to be healthy and able
to learn and reach their full potential. She loves her job
and the opportunity to care for and support the health of
students. She is humble about her efforts that benefit so
very many and for the vision she has for the students of
Utah.
The nomination and selection of a local Champion is
based on meeting one or more of the following criteria:
Leadership; The candidate is considered an authority
on immunizations in their community, medical system,
or individual practice. Collaboration; The candidate has
worked to build support for and increase immunization
rates in infants and young children. Innovation; The
candidate has used creative or innovative strategies
to promote immunizations or address challenges
to immunization in their community. Advocacy; The
candidate is active in advancing policies and best
practices to support immunization in infants and young
children in their community.
When your patients, family and friends
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medical care for their loved ones, trust
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In 2010, the Institute of Medicine released a
landmark report, The Future of Nursing: Leading
Change, Advancing Health, which recommended
increasing the number of nurse leaders in
pivotal decision-making roles on boards and
commissions that work to improve the health
of everyone in America. The Nurses on Boards
Coalition (NOBC) was created in response to
this, as a way to help recruit and engage nurses
to step into leadership roles.
The NOBC represents nursing and other
organizations working to build healthier
communities in America by increasing nurses’
presence on corporate, health-related, and
other boards, panels, and commissions. The
coalition’s goal is to help ensure that at least
10,000 nurses are on boards by 2020, as well
as raise awareness that all boards would benefit
from the unique perspective of nurses to achieve
the goals of improved health in the United States.
We encourage each and every one of
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August, September, October 2018 Utah Nurse • Page 5
“MUSINGS OF CARING”
SELF-REFLECTIVE MOMENTS BY NURSES
Nurses Enhance Patient Care Interactions in Moments of Connection
Sharon K. Dingman, DNP MS, RN
Nurses provide an innate sense of humanness,
connection, and sense of caring in patients’ lives. There
are powerful moments in the delivery of nursing care that
have an extraordinary impact on the patients’ outcome
and create unforgettable moments and memories
(Dingman, 2012 & Thew, 2018). Nurses inform, connect,
engage and advance the profession through their
interactions in creating profound patient experiences.
Moments of connection include authentic empathy,
respectful caring, collaborative awareness, calming
presence, engaged spirit, informed professionals and
quality outcomes (Dingman, 2012).
Caring Defined
Patients and families define caring as accessibility,
communication, caring moments, non-judgmental
attitudes, and competence (Dingman, 1999). Authentic
caring behaviors influence the patient perceptions and
satisfaction with care are listening, offering comfort,
putting the patient first, talking to the patient, responding
quickly to patient needs, being accessible, monitoring the
patient, and following through (Dingman, et al,1999; Utah
Nurse, May, June, July 2018). Nurses are able to connect
with patients and families through conscious authentic
caring moments based on their professional ability,
knowledge, and experience to impact the lives of patients
and families. When meaningful remarkable moments of
great service that happen in a persons’ life and create a
lasting impression…positive or otherwise.
Within health care organizations, profound human
experiences happen every day. Numerous opportunities
abound daily to create the human connections that
differentiate a caring/healing environment from one that
is not. Who we are and how we work together as nurses
is what our patients and their families receive. Even within
a “state of the art” physical facility, with care centered
on the patient and family, and the empowerment of
caregivers at the point of care/service in decision making;
all would be like an empty shell if those providing the
care/service did not feel cared for themselves.
Moments of Shared Connections
There is a “mindful” presence and sensitivity with
professional satisfaction in the nurse-patient partnership
resulting in mutual satisfaction with the care delivered
and received (Dingman, 2012). Connection with the
caregiver and the patient remain primary to patient/
family satisfaction with care and service. Making
moments of shared connection matter builds positive
patient perceptions of care. Opportunities to recommit
to the “passion and purpose” of why an individual works
in health can be a valuable moment of reflection and
renewal. Creating better experiences and better defining
moments provide insights into shared meaning and
connecting with others (Heath and Heath, 2017, 211).
Where caring and healing are present, where visible
regard for dignity of human being, and where those
who give care do so in teams with mutual respect and
accountability there is a palpable sense of well-being.
The identification of 'critical junctures' or moments
of interruption in care delivery are opportunities to
improve and celebrate the contributions of all caregivers
regardless of their role or job in the organization. Patient
satisfaction is an important measurement of quality
by the consumer from their experience with both the
technical and interpersonal elements of care. Patients
and their families value meaningful affective interactions
with care providers. The two components of nursing
affective and technical care are seen as equal in
providing compassionate care (Dingman, 2012). Evidence
based practice (EBP) models indicate professional
nursing practice impacts the patient’s perceptions and
expectations of caring and their satisfaction with care
received (Dingman, 2012).
Patient Satisfaction: Expectations and Caring
Patients need and want education in managing their
illness from nurse(s) using through personalized care
plans that engage and support care outcomes. Not
every patient has the same diagnosis or reason for
hospitalization, but there is a common need for patient
centered care including their diagnosis, education,
and how to incorporate self-management of their
circumstances. Caring interactions from care providers
gives the control to the patient in their own self-care
(Bardsley, 2018). Creating a relationship in this process
influences patient satisfaction and is an important
indicator of quality of care.
Nurse caring must be displayed to be effective and
patient satisfaction is the expression of the match
between patient expectations and caring received.
Caring is a fundamental value that guides nurses’
ethical decision making and provides a basis for nursecaring
action (Dingman, 2012). Patient satisfaction
is measured and used in healthcare to improve care
delivery. Standards of excellence are commonly
measured and associated with financial incentives to
improve the patient experience with nursing and others
involved in delivering care.
Caring Defined
Humanity is expressed holistically to the patient
through compassion and caring by the nurse, especially
during the one-on-one interactions at the bedside
(Dingman, 2012). Caring is defined as an intentional
presence, affective behaviors, personal ownership,
respect for human dignity, genuine service, a partnership,
and as a matter of integrity that is heartfelt, and given
and received between individuals (Dingman, 1999).
Listening and comforting is a vehicle for caring. Heath
and Heath (2017) state “patient experiences are made
by positive moments of elevation, insight, pride, or
connection that spark positive emotions, and received
within defining moments of care.”
According to Dan Heath (2017), “we need to stop
fixing potholes and start building peaks when it comes to
creating better experiences for the people we care about.
When we create better experiences, we create better
moments for our patients and their families. The peak
moments of these experiences with the delivery of health
care are the most memorable. Great service experiences
are mostly forgettable and occasionally remarkable.
People are willing to forget a lot of mediocrity as long as
there are some moments that are special. Remarkable
moments do not happen themselves.” As nurses focus
on the creation of better experiences we build peaks in
lieu of only fixing problems.
Defining Peak Moments
Chip Heath (2017) states, “the identification of ‘defining
moments’ are powerful for organizations in their thinking,
processes, and structures used to create meaningful and
memorable moments that drive financial performance.”
The value of humor the flight attendants of Southwest
Airlines use during the funny safety instructions on the
selected flights (1.5% of flights) have shown that the
people on these flights are likely to take a half of a flight
more in a subsequent year.” If the airline increased this
to 3% the potential increase in revenue would be $139
million a year for the momentary moment created a peak
experience.
Building peaks and creating positive experiences
may be one way to change from a focus on problems
only and allocate time to creating peaks and improving
experiences of patients and families we serve. The
customer experience is created by peak moments
contains four elements: elevation, insight, pride, and
connection. These four elements come up in stories of
customer service and other defining powerful moments
in our lives. Healthcare can build peak moments in the
lives of patients and families.
I think you will enjoy reading the book “The Power of
Moments – Why Certain Experiences Have Extraordinary
Impact” by Chip Heath and Dan Heath as you discover
the relevance of the perspective of the authors and the
application of “the power of moments of elevation,
insight, pride, and connection” in your practice.
Future articles on “Musings of Caring” by Dr. Dingman
will continue to make references to this book.
Invitation to Share “Musings of Caring”
You are invited to share your “Musings of Caring” with
Utah nurses by contributing your reflective observations
and caring stories from your delivery of care to patients
and families. A few examples from a group of nurses’
reflective observations on “being with and doing for”
patients included how they established a relationship;
confirmed trust by patient through listening and
explaining; without judgment listened to patient fears and
concerns; felt empowered as the patient advocate; sat at
eye level to review a plan of care; and worked as a team
with the patient, nurses and physicians (Dingman, 2012).
We look forward to hearing from you!
Note from Utah Nurse Editor and Author of
“Musings of Caring” Dr. Dingman
The idea for the “Musings of Caring” Column
began with the May, June, July 2018 article and using
the personal experiences and scholarly work of Dr.
Sharon K. Dingman as a hospitalized patient before
she became a nurse, experiences as a nurse caregiver,
administrator and educator, and in tribute to the spirit
of the caring nurses provide to patients and families.
“Musings are forms of self-reflection including meditation,
introspection, contemplative, thoughtful, purposeful,
logical and philosophic (Merriam-Webster Dictionary,
2018). Many nurses often share personal patient caring
moments of connection both given and received among
each other. The nursing literature provides examples
of caring and the impact on patient care outcomes.
Musings are therefore personal “moments of caring
presence” with the patient, family and/or significant
others by being present as a nurse in delivering care.
We are extending an invitation to nurses
to share their “Musings of Caring” stories for
publication consideration in future issues of Utah
Nurse.” beginning with the November, December
2018 and January 2019 edition of Utah Nurse.
Guidelines on the submission process for
a short article to be included in the “Musings
of Caring” column are found in Utah Nurse –
Publications on Page 2. Submissions can be sent
to: editor@utnurse.org or mailed Attn: Editorial
Committee, Utah Nurses Association, 4505 S.
Wasatch Blvd. Suite 330B, Salt Lake City, Utah
84124
Selected References:
Bardsley, J. (2018). Educated, engaged patients, better
diabetes outcomes. Retrieved from http://www.
smartbrief.com/original/2018/05/educated-engagedpatients-better-diabetes-outcomes.
Dingman, S. K., Williams, M., Fosbinder, D., & Warnick,
M. (1999). Implementing a caring model to improve
patient satisfaction. Journal of Nursing Administration,
29(12), 30-37.
Dingman, S. K. (2012). Nurse caring enhancements of
The Caring Model©. Unpublished Doctor of Nursing
Practice Project, Department of Nursing, Texas
Christian University.
Dingman, S. K. (2018). The value of a healthy nurse
workforce. Utah Nurse, 24(4) May, June, July ed. Utah
Nurses Association, SLC, Utah, 6.
Heath, C. (2017). The power of moments at Forrester’s
CXNYC. Retrieved from https://www.youtube.com/
watch?v=-l03bHVF0Ok.
Heath, D. (2017). Build peaks, Don’t fix potholes.
Retrieved from https://www.youtube.com/
watch?v=QxXcL28A89M.
Heath, C. & Heath, Dan (2017). The power of moments:
Why certain experiences have extraordinary impact.
Simon & Schuster: New York, NY.
Merriam-Webster Dictionary (2018). Definition of musings.
Retrieved from https://www.merriam-webster.com/
dictionary/musings.
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Utah Nurse • Page 6 August, September, October 2018
A Voice
for Nursing
UNA leaders represent your interests in a wide variety of meetings, coalitions,
conferences and work groups throughout the year, anticipating and responding to
the issues the membership has identified as priorities. In addition to many meetings
with legislators, regulators, policy makers and leaders of other health care and nursing
organizations, the following is a partial list of the many places and meetings where you
were represented during the past three months....
UNA Board Meeting
UNA Executive Director Committee
Interim Health and Human Services Committee
of Utah State Legislature
Utah Nursing Consortium
Utah State Board of Nursing
Academic Leadership Council of UONL
UNA Conference & Advocacy 2018 Planning Meeting
WEX Meeting
Utah Health Policy Roundtable
Sigma Theta Tau Nu Nu Chapter Board Meeting
Sigma Theta Tau Nu Nu Annual Chapter &
Induction Dinner & Awards
Poster Presentation TCM Enhancements to Patient Satisfaction
Utah Board of Student Nursing Association Meeting
Honors for Nursing
GOVA National Meeting (Governmental Affairs of ANA)
National Quarterly President’s Call (ANA)
UACH (Utah Action Coalition for Health) Health Insights
Falls Prevention Committee
We Hire New
Graduates!
The Utah State Hospital, a cutting-edge 325 bed psychiatric inpatient
treatment facility on a 300-acre campus in Provo, Utah located at
the base of the Wasatch Mountains, is seeking Registered Nurses,
Licensed Practical Nurses, and Psychiatric Technicians. Flexible
schedules are available, with excellent benefits including medical,
dental, life insurance, retirement, paid leave, etc. A sign on bonus
is being offered to full time Registered Nurses and Licensed
Practical Nurses, $4,000 to full time RN’s. Apply online at
https://statejobs.utah.gov. Hover over Job Search and click on
Job Listings. Under locations, select Provo, and then click Apply
Search. You will then see the links to the job applications, click on
the one you are interested in. If you have any questions contact
Human Resource Office at 801-344-4271.
Introducing...Liz Close, PhD, RN
UNA's New Executive Director
Liz’s journey to Utah and the UNA Executive Director position has
been, well, unusual. After completing her Master’s degree in nursing at
the University of California, San Francisco (UCSF), she began working
at the University of Utah College of Nursing as a nurse researcher
and project director of federally and foundation funded grants and
as a consultant on nurse recruitment information management and
nursing staff position control at University Hospital (before the era of
computerization!). During her time in Utah, she was an officer of the U
of U Nursing Honor Society which she helped charter as the Gamma
Rho Chapter of Sigma Theta Tau International in 1978. It was during
this time her friends taught her to ski by convincing her to take the
Snowbird tram for her first lessons!
In 1982, Liz accepted an appointment to teach the BSN senior school health nursing
lecture and clinical practicum and serve as the administrative coordinator of the RN-BSN
program for the Pennsylvania State University in central Pennsylvania. She returned to
California in 1987 and worked as the Special Projects Coordinator for the Vice President
of Patient Care Services at Marin General Hospital before being appointed Associate
Professor and Regional Coordinator for the northern California “campus” of the Statewide
Nursing Program at California State University, Dominguez Hills. This was the first
distance learning RN to BSN program in the nation and was delivered throughout the
entire state of California. Liz was only responsible for program delivery north of San
Francisco to the Oregon border!
Liz began doctoral studies in sociology at UCSF in 1990 and completed her PhD
with specialties in health care policy and aging in 1994. Her studies of unpaid labor
(euphemistically known as “informal care”) in the delivery of home care suggested the
structural mechanisms by which the tremendous outflux of hospital care to homes was
achieved in the post-DRG era. In that same year, Liz was promoted to full professor and
awarded tenure at CSUDH. In 1997, she accepted the permanent chair position of the
Sonoma State University (SSU) nursing department in northern California.
Liz retired from academia in 2015 and was awarded Professor Emeritus status at
SSU where she had been Nursing Department Chair for 15 years. During that time,
one of SSU nursing’s many achievements was development and implementation of the
Collaborative Nursing Education Continuum Model for ADN-BSN (“RN-BSN”) education,
in 2009, between SSU and five community colleges in the university’s 8,000 square mile
service area. Liz’s statewide leadership facilitated an unprecedented level of cooperation
and collaboration between community college and university nurse educators and
practice partners in streamlining ADN-BSN education in California. She also served
on the California Board of Registered Nursing Education Advisory Committee for three
years and was elected to the Petaluma Health Care District Board of Directors where she
served in multiple roles for eight years advocating for the nursing profession and patient
safety and quality care.
Liz has been a nurse expert consultant for the Center to Champion Nursing in America
since 2011. In this capacity, she has provided expertise nationwide on the Shared
Curriculum Model as well as other post-licensure BSN and MSN transformational pathways
for increasing the educational level of the nursing workforce recommended in the 2011
IOM Future of Nursing Report. She has also provided service and consultation across the
country on implementation of the Robert Wood Johnson Foundation’s Culture of Health.
Liz is now a member of the Utah Association of Nurse Leaders and has had the great
pleasure of working with the Utah Action Coalition for Health through her role with the
Center to Champion Nursing in America’s Campaign for Action. She moved to Park City
in April 2015 and has been consulting on educational transformation for state community
college and university systems as well as private nursing schools, developing online
graduate nursing coursework in health care finance and working at Deer Valley in the
winter (yes, she did recover from her first tram experience and loves to downhill!).
Liz has purposefully focused the last 25 years of her career on transforming nursing
education and intends to bring the same level of experience, dedication, advocacy and
enthusiasm to supporting the ongoing advancement of nursing in Utah in her new career
chapter as UNA Executive Director.
Her recent publications include:
Close, L. & Orlowski, C. (2015, Dec). Advancing Associate Degree in Nursing-to-
Baccalaureate Degree in Nursing academic progression: The California Collaborative
Model for Nursing Education. Journal of Nursing Education 54(12), 683-688.
Close, L., Gorski, M.S., Sroczynski, M., Farmer, P., & Wartock, J. (2015, Dec). Shared
Curriculum Model: A promising practice for education transformation. Journal of
Nursing Education 54(12), 677-682.
Jones, D., & Close, L. (Nov/Dec 2015). California Collaborative Model for Nursing
Education: Building a higher educated nursing workforce. Nursing Economic$ 33(6),
335-341.
Gorski, M.S., Farmer, P., Sroczynski, M., Close, L., & Wartock, J. (2015, Sep). Nursing
education transformation: Promising practices in academic progression. Journal of
Nursing Education 54(9), 509-515.
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“When HopeWest hires RNs, we look
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To apply visit
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OR Call (970) 257-2364
Equal Opportunity Employer

August, September, October 2018 Utah Nurse • Page 7
American Nurses Association Announces
National Awards Recipients
12 nurses will be honored for transforming health care
The ANA awarded twelve nurses for transforming healthcare, including Utah’s own
Alexandra L Wubbels, BSN, RN.
SILVER SPRING, MD (April 30, 2018) – The American Nurses Association
(ANA) announced its 2018 National Awards recipients. ANA’s National Awards honor
outstanding nurses whose dedication and achievements have contributed significantly
to the nursing profession.
This year’s 12 honorees include two registered nurses who will be inducted into
ANA’s Hall of Fame, and ten registered nurses who will receive Honorary Awards.
A ceremony to honor the 12 award recipients will be held on Friday, June 22, at the
Washington Hilton in Washington, D.C., during ANA’s Membership Assembly.
ANA is honored to celebrate the extraordinary achievements of these nurses, who
are exemplary leaders and advocates, and whose contributions have advanced nursing
and demonstrated ANA’s impact on improving health care for all.
Hall of Fame Award
ANA established the nursing Hall of Fame Award to recognize individual nurses’
significant commitments to the nursing field and their impact on the health and social
history of the United States. ANA first inducted recipients into the Hall of Fame in 1976.
ANA is honored to induct two Hall of Fame Award recipients for 2018:
• Barbara J. Drew, PhD, MS, RN, ANA\California
• Marie Louise Fitzpatrick, EdD, RN, FAAN, Pennsylvania State Nurses
Association
Dr. Barbara Drew’s cardiovascular nursing research has brought valuable
improvements to patient care and nursing scholarship. Her 30 years of research and
publication work, focused on cardiac monitoring, has led to major changes in the
clinical care of patients with heart disease. Dr. Drew has demonstrated an extraordinary
commitment to furthering excellence in nursing science. In her work with organizations,
she has often moved them toward more productive interdisciplinary goals and to the
adoption of clinical guidelines that reflect nursing research and the concerns of clinical
nurses.
The late Dr. Marie Louise Fitzpatrick was a visionary leader and champion for the
nursing profession, international health care and nursing education. Dr. Fitzpatrick
was the Connelly Endowed Dean and Professor of the College of Nursing at Villanova
University – a position she held for nearly 40 years. Under her leadership, Villanova’s
College of Nursing was created and developed into a premier nursing program. She
expanded the college’s academic programs, including initiating the master’s and
doctoral programs, as well as an accelerated BSN program for second-degree
students. Dr. Fitzpatrick developed distance learning strategies and clinical simulation
initiatives with a focus on scholarship and research.
Honorary Award
The Honorary Award recipients are highly accomplished registered nurse leaders
and will be honored for their outstanding service to the profession in categories ranging
from public health to patient advocacy to legislative successes.
The Honorary Award recipients are:
• Gale Adcock, MSN, RN, FNP-BC, FAANP, FAAN
North Carolina Nurses Association
The Barbara Thoman Curtis Award recognizes significant contributions to nursing
practice and health policy through political and legislative activity.
• Valerie Aarne Grossman, MALS, BSN, RN, NE-BC
ANA-New York
The Honorary Nursing Practice Award acknowledges a registered nurse who
is directly involved in patient care who receives recognition by peers for their
contribution to the advancement of nursing through strength of character,
commitment and competence.
• Peggy L. Chinn, PhD, RN, FAAN
ANA\California
The Honorary Human Rights Award recognizes the outstanding commitment to
human rights and exemplifying the essence of nursing’s philosophy about humanity.
• Joyce Fitzpatrick, PhD, MBA, RN, FAAN, FNAP
Ohio Nurses Association
The Jessie M. Scott Award is named after the American nurse who served as
the Assistant Surgeon General and directed the nursing division of the U.S.
Public Health Service, which is now known as the U.S. Department of Health and
Human Services. The award recognizes a nurse who has made an outstanding
accomplishment in a field of practice, education, or research and demonstrates the
interdependence of these elements and their significance for the improvement of
nursing and health care.
• Richard Henker, PhD, RN, FAAN
Pennsylvania State Nurses Association
The Luther Christman Award recognizes the contributions that an individual man in
nursing has made to the profession of nursing.
• Paula K. Anderson, RN
Ohio Nurses Association
The Mary Ellen Patton Staff Nurse Leadership Award was established to recognize
an individual staff nurse who has made significant contributions to the professional
advancement of staff nurses and who has demonstrated leadership in the nursing
profession.
• Jacquelyn Y. Taylor, PhD, PNP-BC, RN, FAHA, FAAN
ANA Massachusetts
The Mary Mahoney Award recognizes significant contributions, by an individual
nurse or a group of nurses, to integration within the nursing profession.
• Alexandra L. Wubbels, BSN, RN
Utah Nurses Association
The Staff Nurse Patient Advocacy Award recognizes staff nurse advocates—
the heroines and heroes on the front lines— for providing direct patient care in
all practice settings and who have advocated for their patients.
# # #
The American Nurses Association (ANA) is the premier organization representing the interests
of the nation’s 4 million registered nurses. ANA advances the nursing profession by fostering high
standards of nursing practice, promoting a safe and ethical work environment, bolstering the health
and wellness of nurses, and advocating on health care issues that affect nurses and the public. ANA
is at the forefront of improving the quality of health care for all.
• Marilyn D. Harris, MSN, RN, NEA-BC, FAAN
Pennsylvania State Nurses Association
The Distinguished Membership Award recognizes outstanding leadership and
contributions to the mission of ANA.
• Michael J. Rice, PhD, APN, RN, FAAN
Colorado Nurses Association
The Hildegard Peplau Award honors contributions to nursing practice through a
lifetime of scholarly activities, clinical practice and policy development directed
toward the psychosocial and psychiatric aspects of nursing care delivery.
FAMILY NURSE PRACTITIONER
Under the direction of the Chief Medical Officer, the Family Nurse Practitioner
(Board Certified), working within a patient centered care team, provides health care
services to clinic patients utilizing professional skills in providing diagnosis and treatment of acute
and chronic health problems along with preventative care focused on health risk factor reduction
within the scope of licensing, training, and privileging/credentialing. Provides care consistent with
medical best practices and the policies/procedures/protocols of the Agency.
Qualifications FNP: MSN and a graduate of an accredited Nurse Practitioner program with a
current and valid Arizona State license with prescribing authority. Have a Valid DEA number, must
be Board Certified. Ability to become credentialed with Canyonlands’ contracted health plans.
For more information, please contact HR at (928) 645-9675 ext. 5505.
Applications are required and are available at the Page Administration site at 827 Vista Ave. or on
line at www.canyonlandschc.org/. Resumes may be attached to the application, but will not be
accepted in lieu of a completed application. EOE. Successful completion of a background check and
drug screen is a prerequisite to employment. Applications are accepted until position is filled.
Relocation bonuses available | Excellent benefits
IHS or NHSC loan repayment program eligible
CONTACT: Michelle Beasley, BSN, RN
Director of Nursing Recruitment
Email: michelle.beasley@fdihb.org
Phone: 928-729-8394 | 928-688-6220

Utah Nurse • Page 8 August, September, October 2018
Career Sphere
10 steps to planning a successful conference
By Catherine Wilson Cox, PhD, RN, CEN, CNE
Reprinted from American Nurse Today, May 2018
Use this guide to plan large and
small events.
DURING MY CAREER as director of programs for
the American Association of Colleges of Nursing (AACN),
my team and I planned and executed 30 national conferences
with 11,500 participants who obtained over four
million continuing nursing education (CNE) contact hours.
And we did it all without a playbook to guide us.
Planning and presenting educational events can
advance your career and give you the satisfaction of
helping your colleagues learn. However, few resources
exist to help guide you through this process. Based on
my experience, whether your event is small or large, the
basic steps are the same. Use these ten steps as you
plan your next (or first) event.
STEP 1 Book the location
If you’re planning a large conference, you’ll issue a
request for proposal (RFP) to conference hotels either
individually or through a conference broker several
years in advance of the event. The RFP should meet
both member and organizational needs and include
information on meeting dates (including hotel guest room
block numbers), meeting space requirements, exhibit
space, and food and beverage orders. Releasing an
RFP early will yield more options. And try to rotate your
meeting sites; if an event is held on the east coast one
year, try to offer it on the west coast the following year. If
you’re planning a smaller local event, book your venue at
least a year in advance for the best options.
Before making your final venue choice, read online
reviews and ensure that factors important to attendees—
such as personal safety, dining options, physical fitness
availability, and no-smoking rooms—are addressed.
After you’ve made your selection, begin your concession
negotiations. You’ll want to negotiate for group rates,
complimentary Wi-Fi in the sleeping rooms and function
spaces, and food and beverage minimums. When
negotiations are complete, secure a contract.
Even with the best intentions, unforeseen events can
happen. The key is to react quickly and calmly.
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For more information:
health.dixie.edu/nursing/rn-to-bsn-program/
STEP 2 Create a budget
Develop your budget based on previous registration
numbers and then estimate the following categories:
travel (both staff and speakers), catering and
accommodations, audiovisual (AV) requirements, and
miscellaneous expenses (for example, maintaining
approved CNE provider status, using abstract
management software, performing electronic conference
evaluations, and running a mobile meeting application).
If prior registration numbers aren’t available, then an
estimate may be “guesstimated” based on a needs
assessment sent to potential attendees. Meeting revenue
will be generated from participant registration fees;
additional expenses can sometimes be slightly offset by
sponsor and vendor income.
Some potential attendees may complain about high
registration fees; however, AV costs can be high; food
and beverage orders are costly (especially when offering
healthy options); and providing Wi-Fi—if not given as
an initial concession when negotiating a contract—is
expensive. The key to handling complaints is to minimize
their frequency by being transparent before, during,
and after the event. Enforcing a cancellation policy that
doesn’t allow full refunds also may garner complaints.
However, to cover the cost of food and beverages that
have to be ordered at least a week in advance as well as
the administrative expenses associated with processing
a refund, you must enforce your policy. Most people will
understand this when it’s explained to them, so, again,
the key to good customer service is transparency.
STEP 3 Build your team
Rely on organizational members to join your planning
committee because they’re the experts when it comes
to recognizing timely topics as well as identifying the
best speakers. Once the planners are identified and
confirmed, create a poll to determine the best four to six
dates and times to meet—either in person or through
conference calls. Choose the dates and times when most
members can meet; you’ll probably never find times that
work for everyone, but don’t hesitate to ask those with
conflicts to rearrange their schedules. Distribute agendas
before each meeting, and circulate minutes as soon as
possible after.
Conference planning takes a lot of time, so think about
how you can compensate your committee members; you
might want to consider waiving their registration fees or
reimbursing travel and hotel expenses. If your budget
can’t support subsidizing conference expenses, explain
this when you invite people to join the committee; remind
them that participating is an opportunity to serve the
profession and can help advance their careers.
STEP 4 Review past event evaluations
Before your first planning meeting, distribute these
documents to the committee members:
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• orientation information
• CNE conflict of interest forms
• a roster of planning members, including contact
information
• an evaluation summary from past meetings
• a conference “planning shell” (an outline with
suggested dates, times, and sequencing based
on past experience)
• a list of themes from the previous years.
When planning an inaugural event with no available
evaluation data, survey your intended audience. During
the first planning meetings, and after reviewing historical
data and audience surveys, generate a list of desired
sessions. You’ll prioritize them at subsequent meetings.
STEP 5 Brainstorm sessions and speakers
By this step, the general planning shells start to take
shape, prepopulated with suggested ideas and ranked
with possible speakers (for example, plan A, B, and C
speakers). This format empowers committee members to
invite another speaker if the first choice isn’t available.
You and your team will start to flesh out topics,
brainstorm catchy titles, finalize themes, and formulate
descriptions so that during speaker negotiations each
presenter knows what content the planners want. If you
want to include poster presentations, use an abstract
management system to manage the call for abstracts,
track the submissions, assign the reviewers, notify the
authors, format the abstract book, and allocate the
rooms at the venue. These systems provide a seamless
process for the event staff, presenters, and attendees.
You and your committee members can review the
abstracts or enlist content experts.
STEP 6 Invite speakers
Now it’s time to invite speakers. Send a formal email
and specify exactly what should be presented and how
speakers will be compensated. Here’s a sample offer:
As a not-for-profit member services association, we
have a modest conference budget. However, we will
waive your conference registration fee and reimburse
your roundtrip coach airfare (but not seat upgrades),
baggage fees, ground transportation (excluding limo
or rental car), one hotel night (room and tax at the
conference rate), and up to $XX against additional
expenses (for example, meals).
As each speaker is confirmed, send any required
CNE forms, ask for a brief biography to be used when

August, September, October 2018 Utah Nurse • Page 9
introducing the speaker, and ascertain AV needs. Also
share tips about how to engage audiences rather than
“death by PowerPoint.” For example, share AACN’s
speaker resources with your presenters (aacnnursing.
org/Professional-Development/Conferences/Speaker-
Resources).
STEP 7 Begin the countdown
Now that the program is in place and the speakers
are locked in, finalize the agenda. When mapping out the
timing of each day, remember to build in breaks, offer an
opening reception if possible, and include downtime for
networking (the number one reason participants attend
conferences).
The next decision is how to process registrations. For
example, will you require all attendees to register before
the event or can they register onsite? Offering a discount
for early registration serves two purposes—it may
entice those with budget concerns and it can help you
anticipate how much food you should order and number
of supplies to have on hand. Then proceed to develop,
publish, and disseminate a brochure.
As you get closer to the date, purchase a meeting
app—which are available from multiple vendors—and
build interactive applications to organize the event and
communicate with your attendees. An app will eliminate
the need for hard-copy conference items, including
evaluation and CNE forms. Also, use this time to review
conflicts of interest with your speakers; if any conflicts
remain, don’t provide CNE hours for that session.
Last, assemble moderator packets for the planning
members so that they’re prepared to introduce speakers
and moderate sessions. These packets should include
speaker biographies, tips for facilitating sessions, and
time cards to alert speakers when time is running out.
STEP 9 Put boots on ground
Now the fun begins. Everything you’ve planned finally
comes to fruition, and the participants and speakers
you’ve been corresponding with have arrived. For large
events, consider hiring local hospitality workers through
a convention bureau to welcome attendees, staff the
registration table, and support your team.
Each day of the event will start early because you’ll
need to work with AV personnel to place equipment and
ensure that all speaker requests are met. You won’t be
able to predict everything that can happen, but you can
always be prepared (take extra batteries for the slide
advancers, additional laptops to replace those that don’t
work, printing cartridges and reams of paper for any
computer stations, and several smart-phone chargers
and charging stations for those who come without). Your
last order of business is to verify the “no shows” and
input the onsite registrations.
STEP 10 Debrief and start planning for next year
Begin debriefing onsite. Note what does and doesn't
work and implement changes right then and there, if
possible. Even the participants’ speaker evaluations
and CNE hours can be moved from a post-conference
activity to an onsite process if you have a meeting app.
Keep your online evaluation survey open for a month
after the meeting, and then pull the results to incorporate
the ratings and constructive comments in your speaker
thank-you letters.
Now get some rest because in a few months, you’ll
start back at Step 1 to begin the process all over again.
Catherine Wilson Cox is an associate professor at the school of
nursing at George Washington University in Ashburn, Virginia.
Fall Prevention
Resources
Presented by The Utah Department of Health
Sally Aerts, PT, MPH
Nearly one-third of Utah adults age 65 years and
older fall each year. Older adults who fall once are twice
as likely as their peers to fall again. Falls are the leading
cause of injury-related death among older adults in our
state and cause 40% of the traumatic brain injuries in
Utah seniors. In 2014, more than $156 million was spent
on Emergency Department and hospital care treating
Utahns for fall-related injuries.
However, falls are not an inevitable part of aging. As
a healthcare provider you can play an important role in
reducing falls. The Utah Falls Prevention Alliance has
created a website with resources for you and your patients.
Learn balance and strengthening exercises and steps to
improve home safety. Find information on handy devices
for getting in and out of cars safely. Connect your patients
to the local Area Agency on Aging, and find locations and
dates of evidence-based fall prevention classes, Stepping
On and Tai Chi, offered throughout Utah.
For additional information on fall risk screening,
consult the CDC’s STEADI (Stopping Elderly Accidents,
Deaths, and Injuries) website. STEADI’s tools and
educational materials will help you to:
• Identify patients at low, moderate,
and high risk for a fall;
• Identify modifiable risk factors; and
• Offer effective interventions.
STEP 8 Attend the pre-con
You may have to travel to the venue one or two days
before the event to make sure your shipments have
arrived. You’ll also attend the hotel pre-conference (precon)
meeting between venue and meeting staff to review
the banquet event orders (BEOs). BEOs include the food
and beverage requests, AV requirements, room setups,
event planner and venue phone numbers to use in
emergencies, and any essential special accommodations
(for example, attendee/speaker food allergies, vendor
support, and special guests).
Selected reference
DeSilets LD. Taking the plunge: Things to consider when
making the decision to provide a national conference. J
Contin Educ Nurs. 2013;44(2):53-4.
Nursing Opportunities Available
• Emergency Room Nurse • Medical / Telemetry Unit Nurse
• Outpatient Clinic Nurse • Outpatient Clinic Nurse Supervisor
Sage Memorial Hospital is located in Northeastern Arizona, Ganado, Arizona
For more information contact: Ernasha McIntosh, RN, BSN, DON,
928-755-4501, ernasha.mcintosh@sagememorial.com.
Applications available at http://sagememorial.com/careers/
Submit applications to the Human Resources Department,
Fax#: 928-755-4659, hr@sagememorial.com

Utah Nurse • Page 10 August, September, October 2018
GRC COMMITTEE REPORTS
UNA Board of Directors
& the State Board of
Nursing Collaborate
on Delegation Rules
Language Change
Diane Forster-Burke MS, RN &
Kathleen Kaufman, MS, RN
Over the past year, Kathleen Kaufman and I have been
working with the Board of Nursing to clarify language in
our Rules related to Delegation of tasks to an unlicensed
person.
Our concerns came about following a meeting in fall
of 2017 at AARP when they discussed caregiving in the
home setting for elderly while adult children are at work.
Health Facility Licensing said they would develop some
Rules for themselves that would outline how an aide
could provide care including medication administration.
Kathleen and I provided extensive feedback and
comments on their draft, however, also determined that
the subject of delegation in the Nursing Rules needed
clarification to ensure patient safety.
The language changes our collaborative BON task
group developed over the past year include the following:
• “Delegator” means a licensed nurse directly
responsible for a patient’s care who assigns to
another unlicensed person the authority to perform
a task on behalf of the delegator.
• Delegation will not be a decision made by an
administrator for the purpose of cost containment.
• Supervision (direct and indirect) was brought into
Rules from DOPL’s Rules.
• The delegating nurse will determine the
competency of the unlicensed aide to perform a
task. Competency can be determined through
an employer sponsored annual skills event, or by
review and onsite demonstration of the task.
On June 14, the Board of Nursing approved the
language and it will now go to a public hearing. There
will be an opportunity to provide public comment or
written comments to DOPL. Once these changes are
published by DOPL, we encourage those of you who
have comments, to direct them to DOPL.
Kathleen Kaufman MS, RN ~ GRC Co-Chair
Or what to do in policy during the Interim Season…..
Think challenging problems, innovative “Utah way”
solutions, air conditioned meetings……a perfect way to
spend at least half a day and learn something new.
The Health and Human Service Committee (HHS)
discusses most of the issues pertinent to nursing and
health care. Unlike some committees that mainly discuss
new bills, this committee discusses issues in depth and
sometimes reviews potential bills. This year the HHS has
identified seven key issues.
They are:
1. Substance Abuse: Continue to address the opioid
epidemic and study how to improve services and
treat substance abuse.
2. Mental Health: Continue to examine Utah’s system
for responding to persons in a mental health crisis.
3. Cannabis: Ensure the appropriate implementation
of legislation passed during the 2018 General
Session.
4. Medicaid Eligibility and Services: Receive reports
on implementation of recent legislation and
continue to hear proposals for reform.
5. Services for Persons with a Disability: Ensure that
there is a suitable system of care for persons with
a disability.
We Can Now Take Action on Fully
Expanding Medicaid in Utah!
Kathleen Kaufman MS, RN & RyLee Curtis,
Director of Utah Decides Healthcare.
As I reported last issue, the Medicaid Expansion
Ballot Initiative did receive more than enough signatures
to be placed on the ballot in November! Thanks to all
of you who worked on this effort generating interest, or
even simply signing the petition for the initiative. Every
signature helped.
Now our task is two-fold, to educate our friends, family
and patients about the need to vote for the proposition.
Many will see the inherent fairness in taking care of
Utahns with very low incomes who have no health
care coverage at work, and thus no access to any care
except for emergencies in the ER. Those who oppose
the proposition should reflect that any non-paying patient
cared for or admitted, will generate a bill that is cost
shifted to those with insurance. So, all people can see
some benefit, regardless of ideological outlook.
The following information is to refresh your knowledge
about the realities of health care access and availability of
funds to pay for this expansion in our state. Please study
this carefully and decide how to vote. Finally get out and
vote! If you are not registered, it is not hard to do. Make a
difference, VOTE. (You can go to the link at UtahDecides.
org under the “about us” tab to register to vote.)
Utah voters should decide what to do with our tax
dollars. For five years Utah has been leaving money on
the table—nearly $800 million in federal funding per year
is already set aside for Utah that we aren’t getting back.
It’s money 33 other states already get, but we’ve been
losing out on for years. Voting yes on the Medicaid
Expansion Proposition will bring those funds home,
provide health coverage to more than 150,000 Utahns,
create 4,100 jobs, and generate $290 million in new
economic activity in our state each year.
The current Medicaid eligibility limits in Utah are
severe—leaving hundreds of thousands of Utahns
without access to healthcare coverage. When Utahns
are denied access to basic insurance they can’t afford
health checkups, they can’t pay for ongoing care and
prescriptions for chronic conditions, and they are forced
to seek treatment in Emergency Departments which
ultimately drives up healthcare costs for all of us.
Utah State Legislature 2018 Interim Topics
6. Prior authorization: Study the impact of prior
authorization on access to timely and appropriate
medical care.
7. Work force needs in the health care professions:
Examine needs in urban and rural Utah including
the possible need for more school nurses.
Rep. Rebecca Chavez-Houck included the last
item based on a request from Dr. William Cosgrove to
look at the needs for school nurses. She considered
the importance of accurate data regarding the Utah
workforce status of all health professions. An increased
need for care due to all other issues in this list may well
demand more professionals in practice. There is a
shortage of healthcare professionals in Utah. This author
notes that the high suicide rate in Utah high schools
might be decreased if there were more school nurses
who KNOW the students in their assigned schools. (This
could occur if one school nurse covered only two or
three schools instead of the typical workload for a Utah
school nurse of six to nine schools.)
The Interim Session begins with meetings in May and
lasts until December. Many meetings are held during this
session; including meetings of committees, task forces,
legislators, and appropriation committees. This session
is where most of the real work of idea development and
new bills for next year gets done. You owe it to yourself to
attend at least one meeting.
This years’ Interim Session has scheduled HHS
Committee meetings at 1:15 to 3:45pm on the 3rd
Utah doesn’t provide Medicaid protections to working
adults without children with incomes less than $17,000
per year. Working parents are also denied access to
Medicaid when their household income falls between
$14,000 and $25,000 for a family of four. A parent
working a low-wage job who gets a promotion or
takes on more hours to get ahead shouldn’t have their
healthcare taken away. When Medicaid covers working
families as they pull themselves out of poverty, we should
reward their hard work—instead of punishing it by cutting
off their healthcare.
Expanding Medicaid in Utah allows Utah taxpayers
to support those in need while promoting individual
responsibility and smart conservative financing. The
Medicaid Expansion Proposition is asking Utah
voters whether they believe raising the sales tax on nonfood
items by 0.15%—equivalent to one cent on a movie
ticket—is a valuable investment to ensure their friends
and neighbors have access to healthcare coverage.
This plan maximizes state dollars and returns the $800
million in federal funding that’s been set aside, back to
Utah. We understand the moral obligation to help the less
fortunate, and this Medicaid Expansion Proposition
strikes the right balance between protecting the
interests of taxpayers while providing necessary health
coverage for Utahns in need.
As part of the work to educate the citizens of Utah,
the Utah Health Policy Project is gathering stories of
people who either did not receive needed care due
to poverty, or those who did qualify for Medicaid and
stayed on Medicaid only long enough to get a job with
health care benefits. If you or your family or friends
know of such a story, ask them to contact Courtney@
HealthPolicyProject.org or call Courtney at 385-499-
7750. Do consider doing this, many of us know at least
one situation/story.
Take action to help the poorest members of our
communities, people who often work minimum wage
jobs for long hours, and no health care benefits. People
who are held to part-time positions so that their employer
does not have to contribute to their health care benefits.
People like you and me who work hard, but, unlike you
and me, they are unable to make ends meet.
Wednesday of most months. The location on Capitol
Hill may vary. Locations, agendas, and associated
documents can be found by going to the le.utah.gov
website and checking the calendar. Final agendas are
required to be posted no later than 24 prior to the meeting.
For those of you who live at distance, audio recordings
of most meetings are available online at the legislative
website. Again, go to the calendar for a past meeting and
look at the minutes and all documents presented during
the meeting. Note that the approved list of issues for HHS
was amended twice during the meeting on May 16th to
include additions by Rep. Chavez-Houck and Rep. Redd.
The posted documents include in-depth material regarding
the current opioid crisis in Utah. Utah is number NINE in
the nation for fatalities due to Opioids. There is a wealth
of information about our state’s statistics and efforts to
counteract the widespread use of opioids.
The UNA GRC Committee and Board of Directors
see to it that the UNA is present at all Health and Human
Services Interim meetings. If you would like to meet one
of us at the Capitol to attend a session, we invite you to
call the UNA office and make arrangements. Liz Close,
our Executive director, can put you in touch with the GRC
Committee. The office number is 801-272-4510. The office
is usually open 9 to 3 on Monday through Thursday.
The bulk of time in meetings consists of experts
presenting key information. Sometimes there is an
opportunity for public comment. These meetings are
good learning opportunities and relatively painless as
are appropriation and task force meetings. You will not
understand all the data but you will learn a lot.

August, September, October 2018 Utah Nurse • Page 11
Practice Matters
FROM YOUR ANA PRESIDENT
The Nursing Now campaign launches
Reprinted from American Nurse Today,
Volume 13, Number 5
Investing in nurses to achieve
global health.
Health should be a recognized universal right. Having
an equitable health system should be a universal
standard. And having highly skilled nurses recognized
for their expertise in providing care and leading efforts to
transform a nation’s health and health system should be
a universal practice.
U.S. nurses are not alone in our quest to be a
prominent voice at all tables in determining how to best
shape and deliver healthcare. Just a few months ago, a
three-year, global campaign was publicly launched called
Nursing Now under the auspices of the Burdett Trust for
Nursing in collaboration with the International Council of
Nurses (ICN) and the World Health Organization (WHO).
More than 30 countries, including the United Kingdom,
Switzerland, South Africa, and the United States, were
represented at launch-day activities held around the
world. Catherine, Duchess of Cambridge, served as the
official patron.
The Nursing Now campaign is focused on improving
health globally by raising the profile and status of nurses
worldwide. The agenda is ambitious, but it’s critically
important and can be accomplished with real investment
in nursing and ongoing support. Nurses and midwives
make up the largest segment of the health workforce
worldwide, and they can have a great impact on the
health and well-being of individuals and communities
because of their expertise and extensive reach through
their varied roles and settings.
That said, we’re facing a global shortfall of nine million
nurses and midwives projected by 2030. The WHO
Triple Impact report, whose findings helped initiate the
campaign, also noted that although there is “enormous
innovation and creativity in nursing,” nurses “are too often
undervalued and their contribution underestimated.”
To achieve its vision, the campaign has developed
goals that are similar to those outlined in the U.S.–
focused Institute of Medicine report, The Future of
Nursing: Leading Change, Advancing Health. Both the
campaign and the report address advancing nurses’
education and professional development, including
leadership skill-building and their ability to effectively
function in rapidly evolving healthcare environments.
The campaign and report also call for increasing nurses’
influence on health policy and engaging nurses in
leadership roles at all levels. And both serve as clarion
calls for investing in the nursing workforce and viewing
nurses as the key to solving many healthcare-related
issues.
Lord Nigel Crisp, former chief executive of the
National Health Service in England, and co-chair of
the international board leading Nursing Now, recently
met with the ICN Executive Committee. In discussing
ICN’s action plans for the campaign, Crisp reinforced
the importance of engaging the world’s nursing leaders
to make an indelible impact on global health, saying, “I
believe that strengthening nursing is one of the single
biggest things we can
do to improve health
globally. Nurses,
wherever they are,
are the health professionals closest to the community
and are invaluable in promoting health and preventing
diseases as well as providing care and treatment.”
As the U.S. representative from the American Nurses
Association to ICN and its first vice-president, I have
the privilege of talking with nurses from many of the
130-plus member countries. I’ve learned that no matter
our country of origin, nurses share the ability to identify
patient and population needs; implement effective, and
sometimes very creative, interventions; and understand
that health promotion and preventive measures are
critical to raising the health of patients, communities, and
nations. Many of us also share similar struggles, although
to varying degrees: staffing shortages, workplace and
societal violence, emerging infectious diseases, and
barriers to practicing to our full education and expertise.
Addressing these, too, will help achieve the impact we
want on global health.
The Nursing Now campaign will run to the end of
2020, which coincides with the 200th anniversary of
Florence Nightingale’s birth and a worldwide celebration
of nurses. I encourage all nurses to learn more about the
campaign at nursingnow.org and to support each other
in leading the way to helping people achieve health.
Pamela F. Cipriano, PhD, RN, NEA-BC, FAAN
President, American Nurses Association
NURSES ON THE NATIONAL FRONT
Breaking news and down-to-the-minute updates
on major health care and humanitarian issues added
urgency and even greater purpose to the final day of
the American Nurses Association’s 2018 Membership
Assembly, held June 22-23 in Washington, DC. Eligible
Assembly representatives adopted recommendations
from the Professional Policy Committee and elected ANA
board and committee members.
Representatives approved recommendations that
were developed following three separate dialogue
forums held the previous day. The three forums focused
on: secondary opioid exposure considerations in
caring for patients with overdose; the ANA presidential
endorsement process; and the ANA position statement
Euthanasia, Assisted Suicide, and Aid in Dying.
The recommendations call on ANA to:
Identify informational tools to inform students
and nurses about responding to patients who have
potential opioid overdose, and advocate for funding
and other support for research and development of
evidence-based protocols regarding opioid overdose.
Refer consideration of the ANA presidential
endorsement procedure back to the ANA Board
of Directors for development of a revised proposal
following further input from ANA members and
stakeholders.
Incorporate the following into a revised position
statement on aid in dying: Nurses must respect
patients’ right to request aid in dying; nurses must be
knowledgeable of the law regarding aid in dying in the
state or territory in which they practice; while nurses
are ethically permitted to participate in aid in dying,
in states or territories where it is legal, they retain the
right to conscientiously object; nurses must be able
to provide information on aid in dying and provide
emotional support to patients and families who face
this decision at the end of life.
New leadership
Eligible voting representatives elected Ernest
Grant, PhD, RN, FAAN, of the North Carolina Nurses
Association as the association’s next president.
2018 ANA Membership Assembly acts on
current issues and looks to a bold future
ANA’s Membership Assembly also elected four
other members to serve on the nine-member board
of directors. The newly-elected board members are:
Secretary Stephanie Pierce, PhD, MN, RN, CNE, of the
Louisiana State Nurses Association; Director-at-Large
Tonisha Melvin, DNP, CRRN, NP-C, of the Georgia
Nurses Association; Director-at-Large Varsha Singh,
MSN, APN, of the New Jersey State Nurses Association;
Director-at-Large Staff Nurse Jennifer Gil, BSN, RN, of
ANA Massachusetts. Additionally, three members were
elected to the Nominations and Elections Committee.
Terms of service for the newly elected members begin
Jan. 1, 2019.
New ANA Enterprise Chief Executive Officer Loressa
Cole, DNP, MBA, RN, NEA-BC, FACHE, addressed the
Assembly, expressing gratitude for the opportunity. Cole
offered her vision of a future where nurses lead. “Our
nation and our patients are counting on us to show up
and speak up,” she said. “We must not fail them. ANA will
be there, and I know you will join us.”
Celebrating a victory
ANA joined other nursing organizations commending
the passage of H.R. 6, the SUPPORT for Patients and
Communities Act, which will extend prescribing authority
to nurses and help combat the opioid crisis. The bill has
moved to the Senate.
By acclamation, the Membership Assembly endorsed
an updated ANA board statement on the Administration’s
practice of separating children from families at the United
States border.
A reflection – and a look ahead
ANA President Pamela F. Cipriano, PhD, RN, NEA-
BC, FAAN, also gave her final Membership Assembly
address. Her term will end at the close of 2018.
Cipriano, who has been an ANA member since
she graduated from nursing school, said that she will
continue to support ANA “from the sidelines,” and called
nurses “the most intelligent and dedicated individuals
who are strong and smart and brave and bold.”
UNA Assembly Representative, Dr. Barbara Wilson
and UNA Executive Director, Dr. Liz Close attended the
conference.
The American Nurses Association (ANA) is the
premier organization representing the interests of the
nation's 4 million registered nurses. ANA advances the
nursing profession by fostering high standards of nursing
practice, promoting a safe and ethical work environment,
bolstering the health and wellness of nurses, and
advocating on health care issues that affect nurses and
the public. ANA is at the forefront of improving the quality
of health care for all. For more information, visit www.
nursingworld.org.
Usually, a healthcare provider’s license is their most important
asset. Disciplinary and malpractice action taken against that
license not only becomes public information, but can have
a devastating impact on one’s ability to practice. Catherine
Larson has over 20 years of experience defending providers in
these matters. Her expertise can help guide you through this
challenging process.
www.strongandhanni.com
clarson@strongandhanni.com • 801.532.7080
102 South 200 East, Suite 800, Salt Lake City, UT 84111
9350 South 150 East, Suite 820, Sandy, UT 84070

Utah Nurse • Page 12 August, September, October 2018
Patient violence: It’s not all in a day’s work
Strategies for reducing patient violence and creating a safe workplace
By Lori Locke, MSN, RN, NE-BC;
Gail Bromley, PhD, RN;
Karen A. Federspiel, DNP, MS, RN-BC, GCNS-BC
Reprinted from American Nurse Today,
Volume 13, Number 5
Robert, a 78-year-old patient, requests help getting to
the bathroom. When the nurse, Ellen, enters the room,
Robert’s lying in bed, but when she introduces herself,
he lunges at her, shoves her to the wall, punches her,
and hits her with a footstool. Ellen gets up from the floor
and leaves the patient’s room. She tells her colleagues
what happened and asks for help to get the patient to
the bathroom. At the end of the shift, Ellen has a swollen
calf and her shoulder aches. One of her colleagues asks
if she’s submitted an incident report. Ellen responds,
“It’s all in a day’s work. The patient has so many medical
problems and a history of alcoholism. He didn't intend to
hurt me. What difference would it make if I filed a report?”
These kinds of nurse-patient interactions occur in
healthcare settings across the United States, and nurses
all too frequently minimize their seriousness. However,
according to the National Institute for Occupational
Safety and Health, “…the spectrum [of violence]…ranges
from offensive language to homicide, and a reasonable
working definition of workplace violence is as follows:
violent acts, including physical assaults and threats of
assault, directed toward persons at work or on duty.” In
other words, patient violence falls along a continuum,
from verbal (harassing, threatening, yelling, bullying,
and hostile sarcastic comments) to physical (slapping,
punching, biting, throwing objects). As nurses, we must
change our thinking: It’s not all in a day’s work.
This article focuses on physical violence and offers
strategies you can implement to minimize the risk of
being victimized.
Consequences of patient violence
In many cases, patients’ physical violence is lifechanging
to the nurses assaulted and those who witness
it. (See Alarming statistics.) As a result, some nurses
leave the profession rather than be victimized—a major
problem in this era of nursing shortages.
Too frequently, nurses consider physical violence a
symptom of the patient’s illness—even if they sustain
injuries—so they don’t submit incident reports, and
their injuries aren’t treated. Ultimately, physical and
psychological insults result in distraction, which
contributes to a higher incidence of medication errors
Alarming statistics
The statistics around patient violence against nurses are alarming.
and negative patient outcomes. Other damaging
consequences include moral distress, burnout, and job
dissatisfaction, which can lead to increased turnover.
However, when organizations encourage nurses to report
violence and provide education about de-escalation and
prevention, they’re able to alleviate stress.
Workplace violence prevention
Therapeutic communication and assessment of a
patient’s increased agitation are among the early clinical
interventions you can use to prevent workplace violence.
Use what you were taught in nursing school to recognize
behavioral changes, such as anxiety, confusion, agitation,
and escalation of verbal and nonverbal signs. Individually
or together, these behaviors require thoughtful
responses. Your calm, supportive, and responsive
communication can de-escalate patients who are known
to be potentially violent or those who are annoyed, angry,
belligerent, demeaning, or are beginning to threaten staff.
(See Communication strategies.)
Other strategies to prevent workplace violence
include applying trauma-informed care, assessing for
environmental risks, and recognizing patient triggers.
Trauma-informed care
Trauma-informed care considers the effects of past
traumas patients experienced and encourages strategies
that promote healing.
67% of all nonfatal workplace violence injuries occur in healthcare, but healthcare represents only 11.5% of the
U.S. workforce.
Emergency department (ED) and psychiatric nurses are at highest risk for patient violence.
Hitting, kicking, beating, and shoving incidents are most reported.
25% of psychiatric nurses experience disabling injuries from patient assaults.
At one regional medical center, 70% of 125 ED nurses were physically assaulted in 2014.
Sources: Emergency Nurses Association (ENA) Emergency department violence surveillance study 2011; ENA Workplace violence toolkit 2010;
Gates 2011; Li 2012.
The Substance Abuse and Mental Health Services
Administration says that a trauma-informed organization:
• realizes patient trauma experiences are widespread
• recognizes trauma signs and symptoms
• responds by integrating knowledge and clinical
competencies about patients’ trauma
• resists retraumatization by being sensitive to
interventions that may exacerbate staff-patient
interactions.
This approach comprises six principles: safety;
trustworthiness and transparency; peer support;
collaboration and mutuality; empowerment, voice,
and choice; and cultural, historical, and gender
issues. Applying these principles will enhance your
competencies so that you can verbally intervene to avoid
conflict and minimize patient retraumatization. For more
about trauma-informed care, visit samhsa.gov/nctic/
trauma-interventions.
Environmental risks
To ensure a safe environment, identify objects in
patient rooms and nursing units that might be used
to injure someone. Chairs, footstools, I.V. poles,
housekeeping supplies, and glass from lights or mirrors
Communication strategies
Effective communication is the first line of defense
against patient violence. These tips can help:
• To build trust, establish rapport and set the
tone as you respond to patients.
• Meet patients’ expectations by listening,
validating their feelings, and responding to
their needs in a timely manner.
• Show your patients respect by introducing
yourself by name and addressing them
formally (Mr., Ms., Mrs.) unless they state
another preference.
• Explain care before you provide it, and ask
patients if they have questions.
• Be attentive to your body language, gestures,
facial expressions, and tone of voice. Patients’
behavior may escalate if they perceive a loss
of control, and they may not hear what you
say.
• Control your emotions and maintain neutral,
nonthreatening body language.
• Strive for communication that gives the
patient control, when possible. Example:
“Which of your home morning routines would
you like to follow while you’re in the hospital?
Would you like to wash your hands and face
first, eat your breakfast, and then brush your
teeth?”
• Offer a positive choice before offering less
desirable ones. Example: “Would you prefer
to talk with a nurse about why you’re upset,
or do you feel as though you will be so
angry that you need to have time away from
others?”
• Only state consequences if you plan to
follow through.
• Listen to what patients say or ask, and then
validate their requests.
• Discuss patients’ major concerns and how
they can be addressed to their satisfaction.
Despite these strategies, patients may still become
upset. If that occurs, try these strategies to deescalate
the situation before it turns violent.
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• Nonverbal communication. “I see from
your facial expression that you may have
something you want to say to me. It’s okay to
speak directly to me.”
• Challenging verbal exchange. “My goal
is to be helpful to you. If you have questions
or see things differently, I’m willing to talk to
you more so that we can understand each
other better, even if we can’t agree with one
another.”
• Perceptions of an incident or situation.
“We haven’t discussed all aspects of this
situation. Would you like to talk about your
perceptions?”

August, September, October 2018 Utah Nurse • Page 13
Patient triggers
Recognizing and understanding patient triggers
may help you de-escalate volatile interactions and
prevent physical violence.
Common triggers
• Expectations aren’t met
• Perceived loss of independence or control
• Upsetting diagnosis, prognosis, or disposition
• History of abuse that causes an event or
interaction to retraumatize a patient
Predisposing factors
• Alcohol and substance withdrawal
• Psychiatric diagnoses
• Trauma
• Stressors (financial, relational, situational)
• History of verbal or physical violence
can all be used by patients to hurt themselves or others.
Remove these objects from all areas where violent
patients may have access to them.
Patient triggers
Awareness of patient triggers will help you anticipate
how best to interact and de-escalate. (See Patient
triggers.) Share detailed information about specific
patient triggers during handoffs, in interdisciplinary
planning meetings, and with colleagues in safety huddles.
What should you do?
You owe it to yourself and your fellow nurses to
take these steps to ensure that your physical and
psychological needs and concerns are addressed:
• Know the definition of workplace violence.
• Take care of yourself if you’re assaulted by a patient
or witness violence.
• Discuss and debrief the incident with your nurse
manager, clinical supervisor, and colleagues.
• Use the healthcare setting’s incident reporting to
report and document violent incidents and injuries.
• File charges based on your state’s laws.
Resources
• American Nurses Association (ANA)
(goo.gl/NksbPW): Learn more about different
levels of violence and laws and regulations, and
access the ANA position statement on incivility,
bullying, and workplace violence.
• Centers for Disease Control and Prevention
(cdc.gov/niosh/topics/vio-lence/training_
nurses.html): This online course (“Workplace
violence prevention for nurses”) is designed
to help nurses better understand workplace
violence and how to prevent it.
Your organization should provide adequate support
to ensure that when a nurse returns to work after a
violent incident, he or she is able to care for patients.
After any violent episode, staff and nurse leaders should
participate in a thorough discussion of the incident
to understand the dynamics and root cause and to
be better prepared to minimize future risks. Effective
communication about violent patient incidents includes
handoffs that identify known risks with specific patients
and a care plan that includes identified triggers and
clinical interventions.
Influence organizational safety
You and your nurse colleagues are well positioned to
influence your organization’s culture and advocate for a
safe environment for staff and patients. Share these best
practices with your organization to build a comprehensive
safety infrastructure.
• Establish incident-reporting systems to capture all
violent incidents.
• Create interprofessional workplace violence
steering committees.
• Develop organizational policies and procedures
related to safety and workplace violence, as well as
human resources support.
• Provide workplace violence-prevention and safety
education using evidence-based curriculum.
• Design administrative, director, and manager
guidelines and responsibilities regarding
communication and staff support for victims of
patient violence and those who witness it.
• Use rapid response teams (including police,
security, and protective services) to respond to
violent behaviors.
• Delineate violence risk indicators to proactively
identify patients with these behaviors.
• Create scorecards to benchmark quality indicators
and outcomes.
• Post accessible resources on the organization’s
intranet.
• Share human resources contacts.
Advocate for the workplace you deserve
Physically violent patients create a workplace that’s
not conducive to compassionate care, creating chaos
and distractions. Nurses must advocate for a culture of
• Emergency Nurses Association (ENA)
toolkit (goo.gl/oJuYsb): This toolkit offers a
five-step plan for creating a violence-prevention
program.
• The Joint Commission Sentinel Event Alert:
Physical and verbal violence against health
care workers (bit.ly/2vrBnFw): The alert,
released April 17, 2018, provides an overview of
the issue along with suggested strategies.
safety by encouraging their organization to establish
violence-prevention policies and to provide support when
an incident occurs.
You can access violence-prevention resources
through the American Nurses Association, Emergency
Nurses Association, Centers for Disease Control and
Prevention, and the National Institute for Occupational
Safety and Health. Most of these organizations have
interactive online workplace violence-prevention
modules. (See Resources.) When you advocate for safe
work environments, you protect yourself and can provide
the care your patients deserve.
The authors work at University Hospitals of Cleveland in Ohio.
Lori Locke is the director of psychiatry service line and nursing
practice. Gail Bromley is the co director of nursing research and
educator. Karen A. Federspiel is a clinical nurse specialist III.
Selected references
Cafaro T, Jolley C, LaValla A, Schroeder R. Workplace violence
workgroup report. 2012. apna.org/i4a/pages/index.
cfm?pageID=4912
Emergency Nurses Association. ENA toolkit: Workplace
violence. 2010. goo.gl/oJuYsb
Emergency Nurses Association, Institute for Emergency
Nursing Research. Emergency Department Violence
Surveillance Study. 2011. bit.ly/2GvbJRc
Gates DM, Gillespie GL, Succop P. Violence against nurses
and its impact on stress and productivity. Nurs Econ.
2011;29(2):59-66.
National Institute for Occupational Safety and Health. Violence
in the workplace: Current intelligence bulletin 57. Updated
2014. cdc.gov/niosh/docs/96-100/introduction.html
Occupational Safety and Health Administration. Guidelines for
Preventing Workplace Violence for Healthcare and Social
Service Workers. 2016. osha.gov/Publications/osha 3148.
pdf
Speroni KG, Fitch T, Dawson E, Dugan L, Atherton M.
Incidence and cost of nurse workplace violence perpetrated
by hospital patients or patient visitors. J Emerg Nurs.
2014;40(3):218-28.
Substance Abuse and Mental Health Services Administration.
Trauma-informed approach and trauma-specific
interventions. Updated 2015. samhsa.gov/nctic/traumainterventions
Wolf LA, Delao AM, Perhats C. Nothing changes, nobody
cares: Understanding the experience of emergency nurses
physically or verbally assaulted while providing care. J
Emerg Nurs. 2014;40(4):305-10.

Utah Nurse • Page 14 August, September, October 2018
Opportunity to Improve HIV Care in Utah
Anastasia S. Borodai, MPH Student
Coordination with the Huntsman Cancer
Institute
The Utah AIDS Education and Training Center
(AETC) is partnering with Huntsman Cancer Institute
to have a better understanding the HIV care continuum
within healthcare systems in Utah. We are conducting
a needs assessment that will assess healthcare
provider knowledge, skills, and comfort level in
providing HIV prevention and treatment services to
patients in order to inform opportunities for training
and capacity building. This will ultimately help to
improve healthcare services for persons living with HIV
in Utah and increase HIV prevention efforts.
We are currently recruiting volunteers for this
survey.
If you are a provider of healthcare services within
the State of Utah, please review the details included
and consider completing the survey. We are honored
to work towards improving care for this patient
population along-side our colleagues.
Utah HIV Provider
Training Needs
Assessment
The Utah AIDS Education and Training Center (AETC)
is partnering with Huntsman Cancer Institute to have a
better understanding the HIV care continuum within
healthcare systems in Utah. We are conducting a
needs assessment that will assess healthcare provider
knowledge, skills, and comfort level in providing HIV
prevention and treatment services to patients in order to
inform opportunities for training and capacity building.
This will ultimately help to improve healthcare services
for persons living with HIV in Utah and increase HIV
prevention efforts.
Who is eligible to participate in this needs
assessment?
Any healthcare provider that delivers care is eligible
to participate, regardless if they currently provide HIV
prevention or treatment services. Participants will take a
25-30-minute web-based survey about HIV prevention,
treatment, and interest in HIV related trainings. The
first 300 providers to participate will receive a $20
Amazon gift card.
How will the information collected be used?
• Improve HIV care among the Utah patient
population
• Determine healthcare provider knowledge, skills,
and comfort
level related to HIV prevention and treatment
• Measure provider training interest and develop
trainings related to HIV care
If you would like to participate in this needs
assessment, please follow the link below:
http://j.mp/2l7FKgK
Questions?
If you have any questions, please contact Laura
Martel by email at Laura.Martel@hsc.utah.edu or by
phone at (801)213-0907.
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August, September, October 2018 Utah Nurse • Page 15
FOUNDATION
Nursing Grant-in-Aid Scholarship Guidelines
The guidelines listed below shall assist in ensuring the best possible coordination in receiving
and processing nursing student requests for scholarships. Scholarships will be awarded for
tuition and books only.
SCHOLARSHIP INFORMATION:
• Scholarships must be postmarked by June 1st or October 1st of each calendar year to
be considered.
• Applicants will receive notice of the Board’s recommendations by July 15th and October 15th
of each calendar year.
• Recipients are only eligible to receive scholarships twice.
• Applicants must abide by the criteria listed below.
GENERAL SCHOLARSHIP CRITERIA:
The applicant must:
• Have a cumulative grade point average, which is equivalent to a 3.0 or higher on a 4.0 scale.
• Be a United States citizen and a resident of Utah.
• Have completed a minimum of one semester of core nursing courses prior to application.
• If a student in undergraduate nursing programs, be involved in the school’s chapter of the
National Student Nurses Association.
• If a registered nurse completing a Baccalaureate Degree or an Advanced Nursing Degree, be
a member of Utah Nurses Association (state only) or a member of Utah Nurses Association/
American Nurses Association.
• Submit a personal narrative describing his/her anticipated role in nursing in the state of Utah
that will be evaluated by the Scholarship Committee.
• Submit three original letters of recommendation. Letters submitted from faculty advisor and
employer must be originals addressed to the Utah Nurses Foundation Scholarship Committee.
• Be enrolled in six credit hours or more per semester to be considered. Preference will be
given to applicants engaged in full-time study.
• Demonstrate a financial need. All of the applicant’s resources for financial aid (scholarships,
loans, wages, gifts, etc.) must be clearly and correctly listed (and include dollar amounts and
duration of each source of aid) on the application.
• The Scholarship Committee shall consider the following priorities in making scholarship
recommendations to the Board of Trustees:
◦ RNs pursuing BSN
◦ Graduate and postgraduate nursing study
◦ Formal nursing programs - advanced practice nurses
◦ Students enrolled in undergraduate nursing programs
• The Applicant is required to submit the following with the completed application form:
• Copy of current official transcript of grades (no grade reports).
• Three letters of recommendation:
◦ One must be from a faculty advisor, and
◦ One must be from an employer (If the applicant has been unemployed for greater than
1 year, one must be from someone who can address the applicant’s work ethic, either
through volunteer service or some other form).
◦ At least one should reflect applicant’s commitment to nursing.
◦ All must be in original form,
◦ All must be signed and addressed to the UNF scholarship committee.
• Narrative statement describing applicant’s anticipated role in nursing in Utah, upon
completion of the nursing program.
• Letter from the school verifying the applicant’s acceptance in the nursing program.
• Copy of ID from National Student Nurses Association or Utah Nurses Association with
membership number.
Nursing Research Grant Proposal
This form is to be used to request research funding assistance from Utah Nurses
Foundation (UNF). Completed forms should be submitted electronically to UNF in care of
the Utah Nurses Association at UNA@xmission.com. Requests will be evaluated based on
need, support for nursing and the nursing profession, and available UNF funds.
Those receiving funds may be asked by UNF to provide personal pictures and narratives to
be published in The Utah Nurse indicating that UNF funds were provided for this project.
Title of project: ___________________________________________________________________
Applicant’s Name and credentials: __________________________________________________
Professional Association/Affiliations (if any): ___________________________________________
Are you currently a nursing student? Yes No
If a student, what nursing school? __________________________________________________
Pursuing what degree? ____________________________________________________________
Have you received funding for this project from any other source? Explain:
1) Describe the proposed work, paying particular attention to the evaluation criteria
listed in the proposal writing guidelines (one page maximum).
Project Overview:
Research Process and Desired Outcomes:
Benefits to Patient Care and Education, Nursing Education,
and /or Nursing Profession:
2) Describe the proposed budget for this project and how you would use the funds
provided (1 page maximum):
3) Provide contact information for you as well as someone who can attest to this project
a) Personal contact information:
b) Contact Information for individual at the School or Facility where research will be
conducted:
Each proposal will be evaluated according to the following criteria. Please address these
criteria in your description of both the proposed work and the budget.
1) The proposed activity benefits patient care, advances nursing education or research.
2) The proposed activity demonstrates merit with regarding to enhancing the discipline of
nursing.
3) The proposed activity clearly describes the desired results or outcomes.
4) The proposal delineates the efficient use of resources, utilizing a complete and
understandable budget narrative.
5) The proposed work offers students and nurses involved a quality, meaningful research
opportunity that will merit submission for publications in a professional journal.
Utah Nurse Foundation use only
Committee discussion of proposal:
Committee decision: Award________________ Do not award________________
Amount Awarded $ ___________________
Is applicant eligible to apply for funds again? Yes______________ No______________
AGREEMENT
In the event of a scholarship award:
• The nursing student agrees to work for a Utah Health Care Facility or Utah Educational
Institution as a full-time employee for a period of one year, or part- time for a period of two years.
• Student recipient agrees to join the Utah Nurses Association within 6 months of graduation
at the advertised reduced rate.
• If asked by UNF, provide personal pictures and narratives to be published in The Utah
Nurse indicating that UNF scholarship funds were received.
• If for any reason the educational program and/or work in Utah is not completed, the scholarship
monies will be reimbursed to the Utah Nurses Foundation by the nursing student.
To download application, visit www.utnurse.org.
Learn how to apply at www.utnurse.org/Education