RN Idaho - February 2019

IDAHO 

Feb, Mar, April 2019 

Volume 41, • No. 4 

Official publication of Idaho Alliance of Leaders in Nursing & Idaho Center for Nursing 

Quarterly publication direct mailed to approximately 25,000 RNs and LPNs in Idaho. 

These organizations are members of the Idaho Center for Nursing. 

ANA IDAHO PRESIDENTIAL REPORT 

Becoming Successful, 

How We Can Do This Together 

Brie Sandow, MSN, RN, NEA-BC, RNC-OB 

ANA Idaho President 

Email: president@idahonurses.org 

The American Nurses 

Association (ANA) provides many 

learning opportunities and I have 

been fortunate to be engaged in 

and to take advantage of many of 

them. This year, I heard a national 

speaker talking about the keys to 

being successful both individually 

and as an organization. Each of 

these aspects shared the same 

three activities skills: surveying, 

collaborating, and communicating. 

Surveying is about looking 

Brie Sandow 

to see what opportunities exist 

that can help to move you and your career ahead. It is also 

what we use to identify barriers and, hopefully, unintended 

consequences. We know from being in the workplace that 

there are nurses that continually survey the landscape for 

opportunities, whether those are about career advancement 

and job change or from the professional perspective of being 

a nurse and constantly surveying what is happening to patients 

and the workflow. 

Don’t Miss Out 

Collaborating is a cornerstone of success both at work 

and individually. So often we hear successful people credit 

others that they have collaborated with for the success that 

they are being recognized for. We want to think of ourselves as 

always being collaborative, but to fully embrace that trait, we 

have to be open to saying yes to opportunities. 

Communicating is the tool that holds the other two 

together. Without communication, what we survey and who we 

collaborate with will not be able to maximize the opportunities 

that are possible. 

Beyond a personal application of these three aspects, 

I want to share with you the surveying, collaborating and 

communicating that is happening within Idaho nursing and 

how ANAI is engaged. Last fall, the ANAI board, along with 

most of the other professional nursing associations in Idaho, 

decided to join the newly formed Idaho Center for Nursing. 

In November we had the first group meeting, which was very 

collaborative and informative about what each organization 

was focused on in terms of member benefits, retaining and 

recruiting members, and upcoming legislative issues; it was 

also a good session to ask and answer questions. 

In terms of surveying, ANAI conducts ongoing surveying 

(environmental scans) to identify issues. Recent scans show 

that nurses continue to be most concerned about workplace 

violence, followed by concerns about nurse staffing because 

Nurses for Idaho! 

Presidential Report continued on page 2 

Join us for Nurses Day at the Capitol, February 21 st , 2019 

INSIDE 

THIS ISSUE 

FEATURE: 

Success of a Nurse Residency Program in a Critical 

Access Hospital 

Franci Marks, BSN, RN PAGE 5 

FEATURE: 

The Evolving Landscape of Non-Cancer Opioid 

Prescribing: Risk Mitigation as a Baseline 

Melanie Nash, DNP, APRN PAGE 7 

Letter from the Editor 

Sydney Parker, MSN, RNC-OB PAGE 2 

Executive Director Report 

Randall Hudspeth, PhD, APRN-CNP/CNS, FAANP PAGE 3 

Save the Dates PAGE 4 

Self-Care Corner: Be Mindful, Be Present 

Katie Roberts, MSN, RN PAGE 4 

Advocacy in Action: 2019 Idaho Legislative Session 

Michael McGrane, MSN, RN PAGE 6 

AWARDS AND RECOGNITIONS: 

Nursing Recognitions PAGE 8 

AWARDS AND RECOGNITIONS: 

Nurse Leaders Peer Group of the Northwest 

Hospital Alliance Receives the Idaho 

Rural Health Heroes Award 

Mary Ann Reuter, Executive Director, IHRA 

Kevin McEwan, MSN, RN Voted to 

AONE Board of Directors PAGE 9 

IDANA Presidential Update 

Gus Powell, MSN, CRNA PAGE 10 

STUDENT SPOTLIGHTS: 

Students Shine at Lewis Clark State College Nursing 

Symposium 

Sydney Parker, MSN, RNC-OB 

current resident or 

Non-Profit Org. 

U.S. Postage Paid 

Princeton, MN 

Permit No. 14 

LIKE US ON FACEBOOK 

Human SIM Lab at Idaho State University 

Lee Ann Hancock and Lindsey Taylor PAGE 11 

In Memoriam PAGE 12 

www.facebook.com/IdahoNursesAssociation/ 

Update from the Idaho Board of Nursing 

Sandra Evans, M.A.Ed., RN PAGE 13 

FOLLOW US ON TWITTER 

@IDAHONURSES 

Update from IALN/NLI 

Karen Neill, PhD, RN, SANE-A, DF-IAFN PAGE 14 

ANA Membership PAGE 15

Page 2 • RN Idaho February, March, April 2019 

Presidential Report continued from page 1 

increasing number of nurses are approaching retirement and 

the numbers of new nurses entering the workforce remains 

stagnant. With increasing patient numbers and severity of 

illness, the demand on nurses will continue to intensify, thus 

impacting staffing needs. The ANA is working to address these 

issues on a national level in terms of staffing guidance. They 

are also in collaboration with the American Organization of 

Nurse Executives (AONE) and the hospital association. Salaries 

have long been an issue, but our 2018 salary survey showed 

that Idaho nurse salaries rank third out of the six surrounding 

states, compared to 7 of 7 in 2012. 

Collaboration is best showcased by our support of 

shared governance initiatives that allow beside nurses to 

have a strong role in decisions that impact the workplace. 

To maximize collaboration, we rely on experience-based 

decisions that benefit the majority and consider the needs of 

many. Collaboration is not always easy, and it requires that we 

address the variables that have an impact, such as funding and 

technology. It also means that we advocate for a seat at the 

decision-making table and have an opportunity to share our 

views. 

LETTER FROM THE EDITOR 


Email: separker@lcsc.edu 

Hello fellow Idaho nurses! The 

season of advocacy and change 

is upon us. Nurses have powerful 

voices and the profound ability 

to influence change. Events on 

February 21-22 (See “Save the 

Dates”) focus around the calling 

of nurses to advocate in the 

political arena and collaborate 

as a profession at the state level. 

I hope this season you find the 

power in your voice, whether 

through political activism at the 

ANA Idaho Welcomes New & Returning Members 

American Falls 

Jessica Schott 

Ammon 

Amy Hope 

Boise 

Marie Berman 

Dori Healey 

Lucas Donaldson 

Maryse Barker 

Julia Koch 

Kelly Hurley 

Rachel Aavang 

Lisa Hotchkiss 

Tammy Gallagher 

Christine Chandler 

Karol Stafford 

Roberta Chilcote 

Linda Crawford 

Sharon Hayhurst 

Alicia Jones 

Burley 

Tephra Oman 

Sydney Parker 

September 2018 - December 2018 

Coeur D’Alene 

Melissa Quaid 

Beverly Oh 

Jan Moseley 

Eagle 

Michael McGrane 

Noreen Davis 

Filer 

Sharon Willmore 

Hayden 

Wendy De Blaquiere 

Janice Matthews 

Idaho Falls 

Emily Mangas 

Kimberly 

Erica Sommer 

Kuna 

Teresa Dixon 

Lenore 

Joan Agee 

Currently in Idaho, nurses have a lot going for them. There is 

a body of evidence that demonstrates that schools of nursing 

collaborate well through articulation agreements. Additionally, 

agencies support nursing education both financially, with 

staffing support, and by increasing clinical placement 

opportunities for students, resulting in increased number of 

nurses. Nurses have had collaborative roles with support for 

legislation, such as the passage of Proposition 2, developing 

new programs to support the underserved, and removing 

barriers to accessing care, especially in rural communities. 

Communication with each other, both within Idaho and 

nationally, to present the concerns and contributions of Idaho 

nurses is important to showcase success and to support these 

contributions. ANAI is focused on that communication. The 

ANAI annual conference this February, our newly designed 

website, and the changes to RN Idaho are examples of 

ongoing communication targeted at all nurses. I encourage 

each of you to visit the ANAI website, and if you are not 

a member, at least be a “follower” of ANAI so you can 

be better informed by receiving the announcements. 

I am looking forward to seeing many of you at the 

Legislative Day and Annual Conference. 

Capitol, authorship for RN Idaho, or engagement in your 

workplace. 

Here at RN Idaho, we continue to be excited about 

recognition, collaboration, and advancing the profession 

through your scholarly work. “Student Spotlights” will 

continue to feature notable student nurse contributions and 

highlights from schools of nursing. The Idaho Center for 

Nursing (ICN) provides an umbrella that fosters partnerships 

between the various organizations in Idaho and we would 

love to hear from yours. We also hope you will send us 

recognitions from your special events, as well as share 

current research, evidence-based practice and quality 

improvement projects. We look forward to continuing to 

foster growth, connection, and the ongoing celebration of 

your accomplishments and dedication to the profession. 

Until next time, 

Sydney 

Lewiston 

Jessica Bringman 

Jason Steik 

Meridian 

Lori McBride 

Susan Tavernier 

Moscow 

Andrea Henson 

Nampa 

Linda Brotcke 

Kelti Baker 

Courtney Kirkpatrick 

Tina Williams 

Cherese Tarter 

Pocatello 

Patricia Young 

Colleen Perkins 

Ann Voda 

Cynthia Rice 

Post Falls 

Pamela Bertram 

Potlatch 

Chris Land 

Preston 

Amy Jensen 

Rathdrum 

Theresa Foster 

Shelley 

Brianne Tolman 

Twin Falls 

Brenna Klinger 

Michelle Harcourt 

Wallace 

Louisa Clark 

IDAHO 

RN Idaho is published by 

Idaho Alliance of Leaders in Nursing 

& Idaho Center for Nursing 

6126 West State St., Suite 306 

Boise, ID 83703 

Direct Dial: 208-367-1171 

Email: info@idahonurses.org 

Website: www.idahonurses.org 

Editorial Board: 


Susan Cline, DNP, MBA, RN, NEA-C 

Margo Hickman, BSN, RN 

Randall Hudspeth, PhD, APRN-CNP, FRE, FAANP, 

ANA Idaho Executive Director (advisory) 

Beverly Kloepfer, MSN, RN, NP-C 

Barbara McNeil, PhD, RN-BC, Editor Emerita 

Gus Powell, MSN, CRNA 

Katie Roberts, MSN, RN 

Mark Siemon, PhD, RN, APHN-BC, CPH 

Christine Westrup, BSN, RN 

RN Idaho welcomes comments, suggestions, and 

contributions. Articles, editorials and other submissions 

may be sent directly to the ANA Idaho office via mail or 

e-mail. Please call the ANA Idaho office if you have any 

questions. 

JOIN ANA IDAHO TODAY 

WE NEED YOU! 

Membership application 

http://nursingworld.org/joinana.aspx 

For advertising rates and information, please contact 

Arthur L. Davis Publishing Agency, Inc., 517 Washington 

Street, PO Box 216, Cedar Falls, Iowa 50613, (800) 

626-4081, sales@aldpub.com. ANA Idaho and the 

Arthur L. Davis Publishing Agency, Inc. reserve the right 

to reject any advertisement. Responsibility for errors in 

advertising is limited to corrections in the next issue or 

refund of price of advertisement. 

Acceptance of advertising does not imply 

endorsement or approval by ANA Idaho of products 

advertised, the advertisers, or the claims made. 

Rejection of an advertisement does not imply a product 

offered for advertising is without merit, or that the 

manufacturer lacks integrity, or that this association 

disapproves of the product or its use. ANA Idaho and 

the Arthur L. Davis Publishing Agency, Inc. shall not 

be held liable for any consequences resulting from 

purchase or use of an advertiser’s product. Articles 

appearing in this publication express the opinions of 

the authors; they do not necessarily reflect views of the 

staff, board, or membership of ANA Idaho or those of 

the national or local associations. 

RN Idaho is published quarterly every 

February, May, August, and November for the 

Idaho Alliance of Leaders in Nursing and the 

Idaho Center for Nursing.

February, March, April 2019 RN Idaho • Page 3 

EXECUTIVE DIRECTOR REPORT 

Thoughts on Membership… 

It is like Voting! 

Randall Hudspeth, 

PhD, APRN, FRE, FAANP 

Executive Director, Idaho Center for Nursing 

Email: randhuds@msn.com 

Exercising your right 

and responsibility to attain 

membership in a professional 

organization is like exercising 

your right to vote in an election. 

Both are always encouraged, 

yet often neglected and hard 

to keep people engaged for a 

variety of reasons. 

I have thought much about 

why nurses choose to join their 

professional associations and 

what makes them renew their Randall Hudspeth 

membership year after year—and 

what happens that prevents those things from happening. 

Realizing that most nurses do not feel the need to belong 

to multiple organizations and knowing they choose the one 

organization that most meets their needs, either through 

continuing education offerings, association or advocacy, 

we can ask ourselves what is the membership attraction? 

Is membership driven by what individuals think they can get 

out of the organization, or is it driven by members wanting to 

be a part of something bigger than themselves? 

Without a doubt, membership numbers impact 

organization sustainability and the organization’s influence to 

represent nursing in the state. The Idaho Center for Nursing 

works regularly with the American Nurses Association of 

Idaho (ANAI), the Idaho Association of Nurse Anesthetists 

(IDANA), Nurse Leaders of Idaho (NLI) and the Nurse 

Practitioners of Idaho (NPI). Each of these are independent 

membership organizations that have affiliate relationships 

with their respective national membership organizations. 

Each of these organizations also has a core group of longterm 

members and none are near their full membership 

potential in Idaho. 

As of December, Idaho has 18,998 licensed RNs that 

live in the state. About 5,000 more RNs are licensed in 

Idaho, but they do not live in the state. Subtracting the 

2,700 APRNs who could be members of NPI or IDANA, 

that yields about 16,000 RNs who could join ANAI. Actual 

membership is about 650. So, what has happened to these 

15,350 RNs who choose not to invest $15.00 a month into 

the profession? 

Personally, I have had my own issues with membership 

and early in my career, I also looked to membership from 

the viewpoint of “what is in this for me and what will I get 

back for this money?” I had to grow-up a bit and then I 

realized that even if I never got anything personally, just the 

satisfaction that the profession was able to advance itself 

and that maybe my membership helped that advancement 

in some small way, was in itself all that I should expect or 

need. 

I believe that history is a good teacher. The history of the 

nurses association in Idaho is no different than most rural 

Western states. These associations have lots of area to 

cover, and usually the majority of members and activities 

are focused in one city, causing rural nurses to consistently 

feel disenfranchised. A membership organization would take 

time, and for these nurses, the demands of family, work, 

and church do not allow for extra time. Historically, the high 

points of the Idaho Nurses Association membership were 

the 1950s and 1960s when annual membership was near 

900 RNs and the total number of RNs in the state was about 

7,000, accounting for about 13% of RN belonging compared 

to today’s 2% of nurses belonging. 

Professionally, at the end of the day membership is 

important. Giving up three fancy coffee drinks a month will 

easily pay the $15.00 monthly dues. I cannot easily convince 

nurses that they should join or that they will get an easily 

seen direct benefit. What I can say is that based on a 40 

year career, I have seen all nurses advance because of 

professional organization engagement. The membership 

support of the few has impacted the careers of the many. It 

is like voting. The votes of a minority of the population serve 

to impact all of the population. Bottom line…join whatever 

professional nursing organization that aligns with your 

practice. The most important professional action you can 

take is membership. Do your part….JOIN! 

Council for Nurse Education Leaders 

(CNEL) Update 

Krista Harwick, DNP, APRN, NP-C 

CNEL President and Region 2 NLI Representative 

Email: klharwick@lcsc.edu 

The Council for Nurse 

Education Leaders (CNEL) is an 

organization comprised of the 

Deans and Chairs of all nursing 

education programs in Idaho. The 

purposes of CNEL are to: 

A. Communicate purposes, 

contributions, and needs of 

nursing education programs 

to professional groups, the 

public, and government 

officials. 

B. Strengthen liaisons 

among nursing education, 

Krista Harwick 

nursing practice, and nursing research through board 

membership in Nurse Leaders of Idaho (NLI), and through 

partnership and collaboration with all participating 

organizations of the Idaho Center for Nursing. 

C. Serve as a network representing all Idaho nursing 

education programs. 

D. Communicate and collaborate with professional 

organizations to promote nursing education in Idaho 

(relevant associations, schools of nursing in the region). 

E. Facilitate opportunities for articulation of nurses from one 

level of nursing education to the next. 

F. Critically analyze legislative initiatives for their impact on 

nursing education in Idaho and the nation. 

Over the past six months, CNEL members reorganized 

with a goal of providing a unified voice for nursing education, 

and promoting articulation through academic and practice 

collaborations throughout the state of Idaho. Idaho schools 

of nursing have a long history of working together to establish 

articulation plans and collaborations that positively impact 

the Idaho nursing workforce. In support of the Institute of 

Medicine (IOM) recommendation that 80% of RNs be prepared 

at the baccalaureate level or higher by 2020, Idaho academic 

institutions have developed innovative pathways to meet this 

goal. Lewis-Clark State College, North Idaho College, and 

the College of Western Idaho developed plans that allow 

students enrolled in community college nursing programs to 

concurrently enroll in online baccalaureate program courses 

known as the CC-BSN Pathway (community-college to BSN). 

The curriculum plans allow students to graduate with their 

baccalaureate degree in nursing in one to two semesters 

following completion of their associate degree. The first 

cohort of students in the pathway began summer 2018, and is 

anticipated to complete associate degrees in spring 2019, and 

baccalaureate degrees in fall 2019. 

In July, CNEL members voted to establish a more formal 

collaboration with Nurse Leaders of Idaho (NLI) and by 

recommendation of the NLI Academic & Practice Committee, 

a change to the NLI by-laws was proposed to add one board 

position to be filled by the President of CNEL. In November, by 

unanimous vote, NLI members approved the by-laws change, 

and the new CNEL board representative will begin their term in 

January 2019. 

#ISaidWhatIWant — 

Have You? 

Stephanie Bender-Kitz, PhD 

Project Lead 

Email: skitz@honoringchoicesidaho.org 

Nearly 20 specialty nursing organizations representing 

more than 700,000 nurses have joined together to promote 

advance care planning (ACP), encouraging nurses to lead 

by example and create their own advance care plan. Even 

though most nurses are familiar with ACP, many do not 

have their own plan in place. This initiative is helping nurses 

create their own plan. 

Advance care planning (ACP) is an ongoing process to 

help individuals and their families think about, discuss, and 

document their goals and values for medical care in lifethreating 

and end-of-life situations. In situations where an 

individual can’t participate in their medical decisions, the 

ACP guides the family and health care providers in providing 

care that honors and supports the individual’s wishes. 

The #ISaidWhatIWant campaign was developed in 

response to work done at the 2017 Palliative Nursing 

Summit hosted by the Hospice and Palliative Nurse 

Association (HPNA). The Summit brought together nurses 

from various specialties to develop a collaborative agenda 

regarding advance care planning, pain and symptom 

management, and transitions/coordination of care. One 

result is this campaign, engaging nurses nationwide to lead 

by example to enhance the care and outcomes for their 

patients and families (https://advancingexpertcare.org/ACP). 

#ISaidWhatIWant starts with nurses. While all members 

of the health care team participate in treatment discussions, 

nurses are in a unique position to champion ACP with 

patients and families. Nurses have regular, ongoing 

conversations with patients and are trusted to provide 

important information and quality care. 

What better way for nurses to demonstrate the value 

of advance care planning than to share with your patients 

and families that you’ve done your own planning. Lead by 

example and think about what you want, talk with your loved 

ones, and establish your own advance care plan. Saying 

what you want is a great gift to your family members if they 

ever have to make difficult health care decisions on your 

behalf. 

There are great resources in Idaho to assist with ACP. 

Honoring Choices® Idaho, a program of the nonprofit 

Jannus, offers free materials, training, and consultation 

to help health care professionals build their ACP skills and 

knowledge. Honoring Choices® Idaho also offers free 

education materials, an easy-to-use advance directive 

document, and depending on where you live, free trained 

ACP facilitators to guide you and your family through an 

ACP conversation. Honoring Choices® Idaho is working 

with health care and community organizations across 

the state to inspire ACP conversations as a routine part 

of good health care. Learn more and use the materials, 

videos, resources, research articles and more at www. 

honoringchoicesidaho.org/isaidwhatiwant. 

If you have already made an advance care plan, help 

your patients and families realize the value of advance care 

planning. Tell your family, friends, colleagues, and others on 

social media why you believe in ACP by using the hashtag 

#ISaidWhatIWant. Start the conversation today! 

Want to learn more about Honoring Choices® Idaho? 

Contact Stephanie Bender-Kitz, PhD, Project Lead at skitz@ 

honoringchoicesidaho.org, call 208.947.4285, and check 

out www.honoringchoicesidaho.org. 

Nurse’s Opinions 

Count…Share Yours! 

ANAI is conducting the 2019 Nursing Opinion 

Survey to evaluate how nurses are impacted by 

current issues to determine ANAI’s engagement 

and resource use with each area of concern. 

Please complete the 

online survey at: 

https://www. 

surveymonkey.com/r/ 

JN3YJHM 

Or use the QR code:


Self Care Corner... 

Be Mindful, 

Be Present: 

Part 1 

Katie Roberts, MSN, RN 

Lewis Clark State College 

Email: kmroberts@lcsc.edu 

The other night as I sat to prepare for 

course work, I looked over and noticed 

my four-year-old sitting on the couch by 

herself watching a television show. At that 

moment I realized it was time to put aside 

my work and spend time with my family. 

All too often it is easy to bring work home, 

especially with technology at our finger 

tips. It is important for our health that we 

are present in our life at all times. 

Often when we think about health and 

wellness we think of diet and exercise. 

However, it is important to also ensure that 

we have healthy minds. Between work, 

family, school, community activities and 

other commitments we are involved in, 

our lives are busy. It is incredibly easy for 

our minds to be at work when we are at 

home and at home when we are at work. 

This can cause our minds and attention to 

not be where they need to which can lead 

to mistakes at work. As nurses, it is well 

known how detrimental those mistakes 

can be. This lack of mindfulness can also 

lead our families to feel neglected. 

According to Belton (2018), stress at 

work can lead to poor patient outcomes. 

Learning to be mindful allows for the 

ability to process what is happening in 

the present. To gain mindfulness, there 

are different skills and workshops for 

participants to learn mindful-based 

interventions, which have been proven to 

help reduce stress and anxiety, ultimately 

leading to better patient outcomes and 

decreased nurse burnout and turnover 

(Belton, 2018). One strategy to achieve 

healthy mindfulness is to draw yourself 

to be present. One way to do that is 

find something that you enjoy: baking, 

gardening, painting, or spending time 

with your family. Whatever you choose to 

participate in, make sure it brings joy and 

space to allow for debriefing and reflection 

so that when you care for your patients or 

family, you can be present and happy. 

References: 

Belton, S. (2018). Caring for the 

caregivers: Making the case for 

mindfulness-based wellness 

programming to support nurses 

and prevent staff turnover. Nursing 

Economics, 36, 191-194. 

CONTINUING EDUCATION 

Our Commitment to Lifelong 

Learning is Focused on You! 

Robin Schaeffer, MSN, RN, CAE 

Executive Director, Arizona Nurses Association 

Email: robin@aznurse.org 

ANA-Idaho (ANAI) is pleased to announce that we 

have re-named our continuing nursing education entity to 

better represent services that are available to every Idaho 

nurse. The old name, Western Multistate Division has been 

replaced with Continuing Nursing Education Group (CNEG). 

CNEG is a partnership between Utah Nurses Association, 

ANAI and Arizona Nurses Association. There are many 

excellent nursing-focused educational programs offered 

in our state, yet some entities have felt intimidated by the 

complexities of the Continuing Nursing Education (CNE) 

application process. The good news is that CNEG has 

improved and streamlined this process! If you would like to 

apply for CNE contact hours for a single event, program or 

activity please visit the new website administrated by our 

Arizona partner www.aznurse.org/CE. You can also access 

this page through the ANAI website. 

All CE is not Equal 

CNEG is an accredited approver of continuing 

nursing education by the American Nurses Credentialing 

Center’s (ANCC) Commission on Accreditation. ANCC is 

considered the “gold standard” for CNE and only accredits 

organizations that demonstrate the use of evidence-based 

criteria and evaluation. 

We Need You…. 

If you like what you have read so far and are looking for 

a way to give back to the association/nursing profession, 

why not consider volunteering as a Nurse Peer Reviewer 

(NPR)? NPRs are trained as volunteer reviewers for CNE 

applications. NPRs are the lifeline of CNEG. Criteria for 

becoming an NPR are listed on the CNEG website www. 

aznurse.org/CE. CE forms and information are available on 

the ANAI website at https://idahonurses.nursingnetwork. 

com/ under “Education & Events”, drop down to “CE 

Applications”. 

Terminology 101: Did you Know? 

• CEU: Is a retired term no longer in use 

• Contact Hours: replaced CEUs 

• CNE: Continuing Nursing Education signifies that 

the continuing education (CE) offered is specific for 

nurses. This is the preferred terminology. 

Everything I Need to Know I Did Not Learn 

in Nursing School! 

Being voted the most honest and ethical profession 

for the last 16 years (Gallup Poll, 2017) suggests public 

assumption that nurses are professionally competent. 

The American Nurses Association (ANA, 2014) defines 

competency as an expected level of performance that 

integrates knowledge, skills, abilities, and judgment. 

ANA also states that the registered nurse is individually 

responsible and accountable for maintaining professional 

competence. Professional competence goes hand in 

hand with lifelong learning principles. Here are some of the 

benefits of CNE: 

RN-BSN Online Program 

• DSUs Nursing 

Department offers a 

RN-BSN program that 

is completely online. 

• Students are admitted 

every fall, spring, and 

summer semester. 

• DSU’s online RN-BSN 

program has no out-ofstate 

tuition. 

• Program completion 

in as little as 2 

semesters with 

full-time enrollment; 

part-time enrollment 

is always available. 

• Enrollment is open 

up to 4 weeks prior 

to the beginning of 

each semester 

To register, call 435.879.4813 

For more information: 

health.dixie.edu/nursing/rn-to-bsn-program/ 

• Validates specialty knowledge, experience and 

judgment for Specialty Certification 

• Impacts patient care quality/outcomes 

• Meets some states’ requirement for licensure 

renewal (Idaho). 

• Promotes professional advancement. 

The Wisdom of Florence 

Let us never consider ourselves as finished nurses…we 

must be learning all of our lives. 

-Florence Nightingale 

References: 

American Nurses Association (2014). Position Statement: 

Professional Role Competence. Retrieved from https:// 

www.nursingworld.org/practice-policy/nursingexcellence/official-position-statements/id/professionalrole-competence/ 

Gallup (2017). Nurses keep healthy lead as most honest, ethical 

profession. Retrieved from https://news.gallup.com/ 

poll/224639/nurses-keep-healthy-lead-honest-ethicalprofession.aspx 

SAVE 

THE DATES 

Nurse Leaders of Idaho (NLI)/Idaho 

Alliance of Nurse Leaders (IALN) 

NLI Board of Directors Meeting, February 20, Boise 

Idaho Nursing Workforce Invitational Meeting, 

February 19, Boise 

Legislative Day at the Capitol, February 21, 9AM- 

12PM, Capitol in Boise 

Legislative Conference, February 21, 1PM-4PM, 

Boise Riverside Hotel 

American Organization of Nurse Executives 

Annual Conference, April 10-13, San Diego 

American Nurses Association Idaho 

(ANAI) 

Legislative Day at the Capitol, February 21, 9AM- 

12PM, Capitol in Boise 

Legislative Conference, February 21, 1PM-4PM, 

Boise Riverside Hotel 

ANA Idaho Annual Conference, February 22, 8AM- 

5PM, Boise Riverside Hotel 

Idaho Association of Nurse Anesthetists 

(IDANA) 

Pre-Conference Aesthetics Workshop & Spring 

Anesthesia Conference, April 12-14, Grove Hotel, 

Boise 

Board of Nursing 

Spring Quarterly Meeting, April 26-27, 2019, Boise 

Summer Quarterly Meeting, July 11-12, 2019, Boise 

Nurse Practitioners of Idaho (NPI) 

AANP National Health Policy Conference, February 

3-5, Washington D.C. 

AANP Region 10 Invitational Meeting, March 9, 

Grove Hotel, Boise 

AANP Annual Meeting, June 18-23, Indianapolis, IN 

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FEATURE 

Success of a Nurse Residency Program 

in a Critical Access Hospital 

By Franci Marks, BSN, RN 

ICU Nurse Manager and Nurse Resident 

Manager, Bonner General Health 

Email: francoise.marks@bonnergeneral.org 

Bonner General Health is a critical access hospital 

located in Sandpoint, Idaho. Due to its location and size, 

recruitment can be especially difficult. In 2015, the hospital 

experienced a significant nursing shortage, which prompted 

the Chief Nursing Officer to look at different opportunities for 

recruitment and retention of nurses. As a solution, a nurse 

residency program was initiated, starting with one new nurse 

graduate. Approximately 18 months into the program, after 

successfully training four new nurse graduates, the program 

was re-evaluated and modified to improve the overall 

experiences of nurse residents while continuing ongoing 

support to meet the hospital’s needs. Through experience 

and feedback from the nurse graduates who had completed 

the program, modifications and adjustments were made 

to better fit the needs of our hospital and the needs of 

the nurse residents. The results have been improved job 

satisfaction and enhanced value of the nurse residents 

to the nursing departments, while decreasing overall 

orientation costs. The purpose of this article is to share 

aspects of instituting and managing a successful nurse 

residency program from the perspective of a critical access 

hospital. 

Nurse Residency Programs 

Hospitals nationwide are facing the challenge of 

recruitment and retention of qualified nurses, particularly 

in specialty areas. The demand for nurses continues to 

increase as many of the existing nurses from the baby 

boomer era are reaching retirement age, which adds to the 

already strained nursing shortage many hospitals are facing 

(AMN Healthcare, 2018). 

One study revealed that turnover rates of newly 

graduated nurses are roughly 30-40% within the first year 

of nursing practice, and up to 57% within the second year 

(Twibell & St. Pierre, 2012). 

Successful mentoring and orientation programs, retention 

of nurses has been shown to decrease turnover rates within 

the first two years, as well as improve retention (Twibell & 

St. Pierre, 2012). Helping new nurses get started on the 

right foot by equipping them with the support they need 

to develop skills for success and make the transition from 

student to career as seamless as possible through a nurse 

residency program is the goal for Bonner General Health. 

With the help of an in-depth orientation and mentorship 

program, new graduate nurses develop more confidence 

and competence, which also helps improve retention. “The 

framework of the nurse residency program is evidencebased, 

and the benefits include reduced turnover, increased 

engagement of new graduates, improvements in patient 

safety and satisfaction, acceleration in RN proficiency, and 

self-confidence” (Fache, 2016). In addition, the Institute of 

Medicine, the National Council of State Boards of Nursing, 

and the Commission on Collegiate Nursing Education 

all advocate for nurse residency programs. Through a 

prospective study across the United States, a one year 

nurse residency program shows a retention rate of 87%, 

along with improved job satisfaction, decreased stress and 

improved clinical and communication skills of the nursing 

graduate (Twibell & St. Pierre, 2012). Since the beginning 

of our nurse residency program in 2015, Bonner General 

Health has a retention rate of 83% of new graduate nurses 

within the first year of employment. 

Program Overview 

Bonner General Health has been teamed up to work 

in conjunction with the Iowa Online Nurse Residency 

Program (IONRP). The purpose of this partnership is 

to develop a nurse residency program with the goal of 

supporting new nursing graduates to become competent 

and confident caregivers, as well as reduce the nursing 

vacancy rate. This is accomplished by providing a focused 

yearlong clinical training and orientation, while concurrently 

developing additional skills through online courses 

provided by the IONRP. Aspects of the online portion of 

the nurse residency program include a combination of 

modules, discussions, webinars, surveys, journaling and 

the completion of an evidence-based project. The online 

component of the program is designed to help develop 

some of the non-clinical skills of nursing. The nurses 

connect with other residents throughout the country 

online with a live instructor for monthly webinars and 

modules designed to support nurses in developing greater 

independence and autonomy with confidence. 

The modules and webinars include a variety of topics 

such as how to deal with legal issues, documentation, 

communication with physicians, change of shift reporting, 

student to RN reality shock, compassion fatigue, conflict 

management, time management and prioritization. The 

IONRP allows the nurses to learn from their peers as they 

share experiences, while offering advice and support to one 

another. At the completion of the IONRP 12-month program, 

the nurse resident receives a certificate of completion and is 

awarded 36 contact hours. 

Probably the most exciting part of the Nurse Residency 

program are the clinical orientation opportunities available to 

the new nurses. The nurses have the opportunity to rotate 

through all of the major nursing departments throughout 

the hospital before receiving a more focused orientation. 

The nurses are given a familiarization tour of the nursing 

departments, which includes Medical/Surgical, Postpartum, 

Labor & Delivery, Surgical Services, Intensive Care 

Unit, and the Emergency Department. The nurse resident 

will spend two weeks in each department with the goal of 

obtaining an overall appreciation and awareness for what 

that department entails and how the department interrelates 

with other areas of the hospital. They also develop a basic 

understanding of the acuity and types of patients that 

department cares for, how the nursing workload is divided, 

and what may be expected for a nurse to work in that unit. 

It is also an opportunity to get to know the culture of the 

department, and whether or not it is a good fit from a social 

perspective. 

During this 10-week familiarization period, the nurses 

work alongside a preceptor and perform nursing duties 

within their scope of practice and level of experience. It is 

not an all-inclusive orientation, and the nurse is not expected 

to be able to function as a fully trained staff during this 

phase. This is not a “shadowing” experience, but rather 

one in which the nurse can begin to grow in any capacity 

available, such as developing relationships and rapport with 

other hospital staff members and gaining an understanding 

of the interdepartmental associations and interactions. 

Track Orientation 

Following the departmental familiarization orientation 

period, the nurse resident selects a nursing department 

of their own interest to receive a more comprehensive 

orientation. At Bonner General Health, three separate 

“TRACK” options were developed in which the nurse 

resident can choose to specialize. In order to meet the 

staffing challenges within a critical access hospital, the 

TRACKs include dual department employment. The 

TRACKS and specialties are: 

• Med/Surg and Post-Partum, with the option to 

specialize in Labor and Delivery 

• Same Day Surgery/Post-Operative Care, or 

specialize in the Operating Room as a surgical nurse 

• Critical Care and the Emergency Department 

Each TRACK will include specialty classes and 

certifications, in addition to BLS and ACLS, as required for 

their area. For example, nurses choosing the critical care 

and emergency department TRACK go through stroke 

training, moderate sedation, rhythm interpretation, critical 

care basics classes, and Trauma Nursing Core Course 

(TNCC). 


Access Hospital continued on page 6



Access Hospital continued from page 5 

Orientation TRACKs were developed in cooperation 

with the departmental nurse managers. Their input 

helped to establish specific time frames required in each 

area, and which classes and certifications are required 

to fully develop proficiency in their department. In most 

areas, a comprehensive orientation will be completed 

in approximately eight months, including classes and 

clinical training. At the completion of the clinical phase of 

orientation, the nurse resident is eligible to apply for a fulltime 

position opening. 

During the second half of the online course, they are 

required to complete a nursing improvement project. The 

project is something the resident sees as an opportunity 

for improvement in the nursing departments, or hospital 

wide, using best evidence-based practices. Once their 

project has been approved, a mentor coaches the nurse 

with their project. It is through research of best practice, 

current policies and protocols, and with some ingenuity of 

their own, that new ideas have been put into practice. One 

example of a nurse residency improvement project was 

the development of a nurse tracking tool and the utilization 

of the current protocol for documentation and tracking of 

central line care. 

Barriers 

Barriers in the beginning of the nurse residency program 

included requiring nurse residents to complete a full 

orientation in every nursing department of the hospital. 

The full orientation was disruptive and prolonged their 

overall orientation time. With the introduction of the TRACK 

system, the nurse residents are happy with their residency 

orientation experiences, and especially appreciate being 

able to choose where they will specialize to receive a 

focused orientation in that area. 

Another barrier was getting buy-in from nurse leaders, 

including departmental managers. Their main concern 

was the financial burden of orienting new nurses, who may 

or may not return to their department to work in the future. 

However, floating and filling in staffing holes showed a 

significant cost savings over having to pay overtime or hire 

a traveler. Essentially, orienting the nurses to the various 

departments ended up saving the departments money in 

the long run. Within the first two years of the nurse residency 

program, the nurses filled staffing holes for a total of 3,991.5 

hours. In comparison, the difference in savings of utilizing 

a nurse resident over a traveler was $156,107 and $88,931 

over paying another nurse overtime. 

Conclusion 

The nurse residency program was designed not only 

to create a smooth transition from student to career in 

the new graduate nurse, but also to instill confidence 

and competence when entering the clinical setting. Job 

satisfaction has an enormous impact on staff. When a nurse 

feels welcome, valued, has support, and feels a part of the 

organization, he or she is more likely to maintain a longterm 

relationship with their employer (Land, McCurdy, Scott, 

Baas, & Clark, 2013). Studies have shown due to the high 

turnover rate of employment within the first year for new 

graduate nurses, the estimated financial loss is $40,000 

per person (Hofler, 2016). When interviewing new graduate 

nurses, it was discovered that the nurse residency program 

is very desirable for new nurse graduates. When asked 

why students applied to Bonner General Health, time after 

time the response has been the same: “For the residency 

program and all the opportunities it provides for new 

graduate nurses.” 

References 

AMN Healthcare (2018). Baby boomer nurse retirement 

wave hits, magnifying nurse shortages for the next 

decade. Retrieved from https://www.amnhealthcare. 

com/latest-healthcare-news/nurse-retirement-wavehits/ 

Hofler, L. (2016). Transition of new graduate nurses to the 

workforce: Challenges and solutions in the changing 

health care environment. North Carolina Medical 

Journal, 77(2), 133-136. doi: 10.18043/ncm.77.2.133 

Land, K., McCurdy, H., Scott, W., Baas, B., & Clark, L. 

(2013). Effects of New Graduate RN Residency 

Programs on Job Satisfaction and Retention Rates. 

Retrieved from: https://www.researchgate.net/ 

publication/259105337_Effects_of_New_Graduate_ 

RN_Residency_Programs_on_Job_Satisfaction_and_ 

Retention_Rates_A_Literature_Review 

The University of Iowa School of Nursing. (2018). Iowa 

Online Nurse Residency Program. Retrieved from: 

https://uiowa.edu/ionrp/ 

Twibell, R., & St. Pierre, J. (2012). Tripping over the welcome 

mat: Why new nurses don’t stay and what the 

evidence says we can do about it. American Nurse 

Today, 7(6), 3. 

ADVOCACY IN ACTION 

2019 Idaho Legislative Session 

By Michael McGrane, MSN, RN 

ANA Idaho/NLI Lobbyist 

Email: mcgraneconsulting@gmail.com 

The 2019 Idaho Legislature has been in session since 

Monday, January 7th when our new Governor, Brad Little, 

delivered the State-of-the-State address. Approximately 

25% of the legislators are new this year. They began 

with orientation meetings early in December, along with 

leadership elections, committee assignments and several 

sponsored events to introduce members, new and old, to 

the issues and agendas pushed by various associations and 

groups. 

Top of the list this year will be healthcare and the 

successful voter initiative to “Close the Gap” by extending 

Medicaid to those working adults who previously would 

not qualify for Medicaid coverage or who earn too little to 

receive support to purchase health insurance on the Idaho 

Exchange. Traditionally, this issue has been a tug-of-war 

between conservative legislators who oppose entitlement 

programs and resist federal intrusion into state affairs, and 

those who recognize the extraordinary cost of healthcare 

and insurance and the desperate consequences faced by 

those making too little to afford needed care. By now there 

are likely to have been many attempts to forestall the voter 

initiative, restrict state funding, add additional requirements 

to qualify for Medicaid, or otherwise inhibit implementing 

what 60% of Idaho voters approved in November. This issue 

may carry through the entire legislative session. 

We all have a role to play 

in preparing Idaho for the 

challenges of responding to 

a public health emergency or 

natural disaster. Please share 

your nursing skills by registering 

with the Medical Reserve Corps 

in your area. Training is free. 

Join us today! 

www.volunteeridaho.org 

As the legislature convenes in January, the initial work 

is to review new Administrative Rules. In Idaho, all new 

rules proposed by the Governor, State Departments and 

Agencies, and Professional Boards, such as the Board 

of Nursing, must be adopted by the Legislature before 

becoming effective. 

The Board of Nursing proposed three rule changes: 

• To revise the definition of “nurse apprentice” to allow 

recent nursing graduates to work in a non-licensed 

capacity; 

• Remove obsolete language regarding multistate 

licensure as a result of Idaho’s; acceptance of the 

enhanced nurse license interstate compact, and 

• Simplify language regarding prescriptions written by 

advanced practice registered nurses (APRNs). 

Once all the new administrative rules are reviewed, 

House Representatives and Senators begin introducing 

legislation. There are deadlines for introduction and 

extended deadlines for Senate and House leadership. Over 

the session, hundreds of bills are heard, but only a fraction 

make it through a convoluted process to be signed into law 

by the Governor. Healthcare bills originate in the House and 

Senate Health and Welfare Committees. Representative Dr. 

Fred Wood (R-Burley) is chairman of the House Health and 

Welfare Committee and Senator Lee Heider (R-Twin Falls) 

is chairman of the Senate Health and Welfare Committee. 

Quality, Utilization Review, and 

Clinical Documentation Improvement 

QUAD RN 

CMH is accepting applications for a full-time QUAD RN. 

This position prefers an RN with clinical experience with 

an emphasis in quality and a current CPHC certification (or 

obtained within one (1) year of hire date). 

The applicant will work within utilization review and regulatory 

compliance as well as conduct documentation review and 

lead quality-based initiatives within the facility. 

This position is forty (40) hours/wk, Monday-Friday. 

On call is not required, however applicant needs to be available 

by phone to answer job related questions when necessary. 

Applications can be printed at CMHLC.ORG. 

Fax - 208.547.2913 | Phone - 208.547.2760 

During “Nurses Day at the Capitol” (see below for more 

information), there will be an opportunity to sit in on the 

House Health and Welfare Committee hearing, observe 

the process, and even testify if desired. This is a great 

opportunity for nurses to interact with legislators, provide 

professional expertise and influence laws that affect access 

and delivery of healthcare. The legislative session generally 

runs into the last week of March or early April. 

In addition to the Board of Nursing rules, other issues to 

watch: 

• An effort to extend pay parity to Nurse Practitioners 

(NPs) who provide the same level of care as 

physicians for specific procedures; 

• The addition of NPs to the list of those protected 

from discovery for medical peer review activities; 

• Reconsideration of the law that allows prosecutors 

to charge those who attack healthcare workers with 

a felony in addition to other criminal charges; 

• Bills to help address the opioid crisis; 

• Extension and funding for suicide prevention and 

mental health coverage; 

• Childhood immunization requirements, and 

• Efforts to modify the religious exemption to Idaho’s 

child welfare law to protect children facing life 

threatening illnesses. 

Nursing is the most highly regarded profession. 

Thursday, February 21st is your opportunity, along with 

many other nurses, to become involved and visit with your 

representatives in the legislature about issues important to 

nursing. 

2019 Nurses Day at the Idaho State Capitol Agenda 

• 0700-0900 Informal meetings with Senators and 

Representatives 

• 0900-1100 ANA Idaho/NLI Booth, House 

Committee Meetings, 1st Floor Rotunda 

• 1100-1200 House and Senate floor recognition


FEATURE 

The Evolving Landscape of Non-Cancer Opioid Prescribing: 

Risk Mitigation as a Baseline 

Melanie Nash, DNP, APRN 

President, Nurse Practitioners of Idaho 

Email: nash@gonzaga.edu 

Opioids have a bad reputation and with good reason. The 

Centers for Disease Control (CDC) 2017 data showed 68% of the 

72,287 drug related deaths in the U.S. were attributed to opioid 

overdose (Ahmad, Sutton, Spencer, Warner, & Sutton, 2018; 

CDC, 2018). We have all been touched by this modern epidemic. 

Despite a ten-year decline in national opioid prescribing, in 

2017, Idahoans received 64.1-82.8 opioid prescriptions per 100 

persons. Health care providers, both RNs and APRNs, are on 

the forefront of the battle to treat pain, minimize suffering and 

mitigate opioid risk for our clients, clinics, and communities. The 

purpose of this article is to present strategies for safer opioid 

prescribing to patients with non-cancer pain. 

Melanie Nash 

Mitigating Opioid Prescribing Risk 

Risk mitigation includes strategies and tools employed to identify clients at risk for opioid 

misuse, abuse, addiction and overdose (Chaudhary & Compton, 2017). Risk mitigation 

practices provide a roadmap for safer opioid prescribing and set protective mechanisms in 

place for the patient, the public and the health care team (Minegishi, Garrido, Pizer, & Frakt, 

2017). 

The risk mitigation toolbox, discussed in further detail below, is filled with a growing 

selection of options. Today, APRNs are educated to use multiple tools to assess and monitor 

opioid effectiveness, assess a patient’s risk for misuse, abuse, diversion, and addiction, and 

provide patients with education on risk, tolerance and dependence. 

Pain Contracts 

Pain contracts are most often used in prescribing opioids for chronic pain. The term 

“contract” is misleading, as pain contracts are not legally binding (Chaudhary & Compton, 

2017). In my practice, I use the term “informed consent” for opioid pain medication instead 

of pain contract. Pain contracts provide information on medication side-effects, such 

as dependence, constipation, reduced gonadotropin production, diminished immune 

response, reduced cognition, and the development of tolerance, and describe the 

provider’s responsibility in prescribing, monitoring use, and reordering. Furthermore, these 

contracts stipulate the provider’s expectation and response for requests for early refills, lost 

medication, urine toxicology screening, and State Board of Pharmacy scheduled medication 

data reviews. The client agrees to accept responsibility for use, home management of the 

medication, and to use the opioid medication for the prescribed condition. 

UTOX 

Urine toxicology (UTOX) testing is an essential tool used to monitor prescribed 

medication use, or not-use, and co-substance use (Ahmad et al., 2018). A negative drug 

screen may signal diversion of the prescribed medication. Be aware, however, that a 

negative drug screen may occur in the client with minimally prescribed doses. For example, 

a random urine drug screen might fail to detect irregular use if the dose is too low or the 

patient takes his entire prescription in the first two weeks of a monthly allotment, but then 

is tested at the end of the month. An important caveat is for the provider to know the 

sensitivity and specificity of the urine drug screening test and for what substances it tests. 

Designer drugs like Kratom and Bath Salts are not discoverable per urine drug screens (D. 

Bankhead, personal communication, November 2018; Ahmad et al., 2018). 

State Prescription Monitoring Programs 

State Prescription Monitoring Programs, through the State Board of Pharmacies, have 

expanded to all 50 states, Guam, Puerto Rico, and the District of Columbia. Licensed 

registered providers must register with the Board of Pharmacy to access this database. 

Interstate interoperability, and interstate drug monitoring compacts, are a new and evolving 

tool to monitor multistate prescriptions (Sacco & Sarata, 2018). For example, I currently have 

access to seven additional states, most of which are contiguous, or close to Idaho. 

Abuse Deterrent Formulations 

Abuse Deterrent Formulations are physical and/or chemical alterations that resist 

tampering. The goal is to block unintended administration through modalities such as 

chewing, snorting, smoking, and intravenous (IV) use (Litman, Pagan, & Ciceero, 2018). 

Furthermore, costs are high and many insurances will not preauthorize or reimburse for 

prescriptions. 

Risk Assessment Tools 

Specific Risk Assessment Tools are formal screening tools used to gauge the risk of 

opioid use and dependence (dela Cruz & Trivedi, 2015). For example, the Stratification Tool 

for Opioid Risk Management (STORM), the Current Opioid Misuse Measure (COMM), the 

Screener and Opioid Assessments for People in Pain (SOAPP), and the SOAPP-R show 

reliability (Menigishi et al., 2017). Their utility is limited by the time involved to administer 

the testing and the transferability between patient populations (dela Cruz & Trivedi, 2015, 

Meltzer E. R., 2009). 

Use of Narcan 

Narcan is an essential tool to combat opioid overdose and death. Narcan (Naloxone) 

should be prescribed to all patients on chronic opioids. Chronic opioid patients and their 

significant others/family need education on the signs of overdose and administration of 

Narcan (Kelly, Falleh-Sohy, Christello, & Bergman, 2017). 

Stacey St.Amand and Lachelle Smith 

Idaho Department of Health and Welfare 

Email: Stacey.stamand@dhw.idaho.gov 

A unique collaboration among the Idaho Department of Health and Welfare, the 

University of Idaho, and Washington, Wyoming, Alaska, Montana, Idaho (WWAMI) Medical 

Education Program brought a state-of-the-art healthcare program to Idaho this year. 

Developed by the University of New Mexico Health Sciences Center, Project ECHO 

(Extension for Community Healthcare Outcomes) was created to deliver medical education 

and care management to primary care practitioners in remote, medically underserved 

communities. Delivered through a telehealth model, its goal is to help alleviate practitioner 

shortages by providing specialty diagnosis and treatment knowledge to practitioners right 

in their own communities. 

Project ECHO started in 2003 as an attempt to help doctors in rural New Mexico treat 

a widespread outbreak of hepatitis C. By 2006 primary care providers in the state were 

acquiring new skills to treat mental health disorders, substance abuse, gestational diabetes, 

and rheumatologic diseases. It has now evolved into an ongoing, globally-recognized 

program that brings rural practitioners and disease specialists together online to share 

knowledge and increase treatment capacity of complex conditions. The goal is to use 

existing resources to provide the same access to care and quality of treatment in rural 

areas as patients receive in urban areas. 

The Hub and Spoke Model 

The ECHO model has transformed medical education to increase workforce capacity 

by linking specialists – operating as “hubs” – with primary care physicians, nurses, and 

other clinicians in rural communities – the “spokes.” They participate in virtual teleECHO 

clinics that are supported by teleconferencing technology. During the clinics, practitioners 

present cases to each other and to the specialists who act as mentors and colleagues, 

sharing their expertise. The model enables the provision of best-practice care to patients 

right where they live. Project ECHO has now replicated its program, operating more than 

120 hubs for at least 60 diseases in 23 countries. 

ECHO Idaho 

Here in Idaho, with support from the Idaho Department of Health and Welfare’s 

Statewide Healthcare Innovation Plan (SHIP), ECHO Idaho’s first virtual teleECHO clinic was 

launched in March 2018. Focusing on Opioid Addiction and Treatment, the clinics offer 

Project ECHO Comes to Idaho 


Prescribing continued on page 14 

a discussion of best practices from the specialist panel that includes an: MD Pain Specialist, 

NP, PharmD, MD Addiction Specialist, MD Physiatrist, and LCSW. During sessions, 

everyone teaches and everyone learns as community providers learn from specialists and 

from each other, and specialists learn from providers as best practices emerge. 

A second clinic began in September focusing on Behavioral Health in Primary Care. 

ECHO Idaho is also exploring opportunities for delivering medication-assisted treatment 

(MAT) education to physicians, nurse practitioners, and physician assistants. 

Enrollment in ECHO clinics is free and each ECHO clinic is designated for a maximum of 

1.0 AMA PRA Category 1 Credit. 

To learn more about ECHO Idaho visit: www.uidaho.edu/echo, email: echoidaho@ 

uidaho.edu, or call 208-364-4698. ECHO Idaho is led by the University of Idaho and 

WWAMI and is supported by Funding Opportunity Number CMS-1G1-14-001 from the U.S. 

Department of Health & Human Services, Centers for Medicare & Medicaid Services.


CELEBRATE 

NURSING 

RECOGNITIONS 

The November edition of RN Idaho highlighted 

nurses recognized at the “Celebrate Nursing Dinner” 

on September 13, 2018 held in Boise. This event, 

hosted by Nurse Leaders of Idaho (NLI), serves to 

celebrate the accomplishments and efforts of all 

nurses in Idaho and this year individual organizations 

were invited to select their own nurse recipients for 

recognition. 

The following nurses were recognized by Saint 

Alphonsus Regional Medical Center for their notable 

contributions through Daisy Awards and other 

organizational recognition. 

Steven Hunt, 

RN 

General Surgical, Boise 

LaRee Miller, 


Elm Clinic, Caldwell 

Saint Alphonsus Regional 

Medical Center, Boise 

Note: This is LaRee’s 2nd 

DAISY Award! 

CATEGORY: 

“DAISY AWARD RECIPIENTS” 

Tracy Goff, 


Emergency Department, 

Boise 

Malherbe Desert, 


Emergency Department, 

Boise 

Gail Snyder, 


Saint Alphonsus Medical 

Group OB/GYN, Mulvaney 

Saint Alphonsus Regional 

Medical Center, Boise 

CATEGORY: 

“OTHER RECOGNITIONS” 

Kara Abel, 


Transitional Observation Unit, 

Boise 

Note: This is Kara’s 2nd 

DAISY Award! 

Scotti Hughes, 


Family Maternity Center, 

Boise 

Misti Leavitt, 

MSN, RN, Interim Director 

of Acute Care SARMC 

Recognized for her 

nomination for the highest 

award given at Saint 

Alphonsus as a President’s 

award nominee. 

Hannah Lundie, 


General Surgical Unit, Boise 

Laurie Spofford, 


Rehabilitation, Boise 

Claire Jones, 

MSN, RN, Director of 

Critical Care SARMC 

Recognized for her work in 

establishing the first Idaho 

Board of Nursing sanctioned 

Critical Care Residency 

Raul Huerta, 


Neurosciences, Boise 

Note: This is Raul’s 2nd 

DAISY Award! 

Sara Keen, 


Medical Oncology, Boise 

Eric Swearingen, 

RN, Clinical Coordinator SARMC (No Picture) 

Recognized for his key role in the tragic events of June 30th, 

2019, a multi-victim stabbing. 

Elizabeth Barber, 

RN, SAHS Health Alliance (No picture) 

Recognized for her outstanding work with the Saint 

Alphonsus Health Alliance complex care management.


Nurse Leaders Peer Group of the 

Northwest Hospital Alliance Receives the 

Idaho Rural Health Heroes Award 

by Mary Ann Reuter, Executive Director, IHRA 

Email: ma.reuter@yahoo.com 

Tari Yourzek, RN, Chief Nursing Officer at Boundary 

Community Hospital, received the Rural Health Heroes 

Award as a part of the Nurse Leaders Peer Group of the 

Northwest Hospital Alliance. Rural Health Association 

President Mary Barinaga, MD, presented the award. 

The Nurse Leaders Peer Group is comprised of the Chief 

Nursing Officers of alliance hospitals. Tari Yourzek is 

chairperson for the group. 

The Northwest Hospital Alliance includes the rural 

critical access hospitals, Boundary Community Hospital, 

Bonner General Health, Benewah 

Community Hospital and 

Shoshone Medical Center, that 

partner with Kootenai Health 

Medical Center in Coeur d’Alene. 

The Nurse Leaders Peer 

Group was nominated to receive 

an Idaho Rural Health Heroes 

award because of the many ways 

its members work to raise the 

profession of nursing to its highest 

level, and because of the Nursing 

Grand Rounds program that 

formed from the group’s efforts. 

The awards are given a week 

before National Rural Health Day 

in Idaho (November 15th this 

year) to recognize rural health 

educators, community advocates, 

healthcare providers and program 

administrators who demonstrate 

Lee Ann Hancock, Director of Divisional 

Marketing & Communications 

Lindsay Taylor, College of Nursing Career Path 

Intern 

Email: hanclee@isu.edu 

Anita Smith, Ph.D., is the new dean of Idaho State 

University’s newly formed College of Nursing. Dr. Smith, who 

joined ISU in August, oversees programs at the Meridian and 

Pocatello campuses. Prior to ISU, Dr. Smith worked for the 

Bureau of Navy Medicine at the Defense Health Headquarters 

in Falls Church, Virginia, serving with the rank of captain. She 

previously held academic appointments at the University of 

South Alabama and Point Loma Nazarene University. 

“We are very excited about the incredible experiences and 

leadership that Dr. Smith brings to ISU,” said Rex Force, ISU 

vice president for health sciences. 

Dr. Smith received her bachelor’s and master’s degrees 

at the University of Washington and her doctorate from 

the University of San Diego. She has also held leadership 

positions with the Veterans Administration. Her diverse 

nursing background includes several deployments to active 

military action including Iraq and Afghanistan as well as 

maternal/child, trauma, school, and post-operative nursing. 

“I am thrilled to join the ISU School of Nursing. It is an 

honor to serve with the faculty and staff who support learning 

and discovery, access to opportunities in nursing, and most 

importantly, prepare future nurse leaders who will bring 

compassionate and innovative care to rural settings,” Smith 

said. 

“Dr. Smith brings a wealth of nursing experience to the 

dean position at ISU. She has a keen desire to live and work 

in the western part of the U.S., and ISU is fortunate to have 

someone with her experience and commitment to nursing 

and nursing education,” said Nancy Renn, former interim 

dean for the College of Nursing. 

After nearly a decade of planning, the School of Nursing 

officially became the College of Nursing in July this year. 

This is a huge step for the faculty, staff, leadership team, 

outstanding service and dedication to rural communities. 

The Idaho Rural Health Association (IRHA) is a nonprofit 

membership organization that provides leadership on rural 

health issues through advocacy, communication, education 

and collaboration. As the recognized voice for rural health 

issues in Idaho, IRHA offers a forum for health professionals, 

community members and healthcare organizations to 

work together to identify and find solutions to rural health 

problems. The Idaho Alliance of Leaders in Nursing (IALN) is 

an organizational member of IRHA. 

Read the stories of all the 2018 Idaho Rural Health 

Heroes at www.idahorha.org. 

Dr. Mary Baringa, MD with award recipient, Tari Yourzek, RN 

New Dean for the New College of Nursing 

at Idaho State University 

Anita Smith, PhD, RN 

and students at the 

College of Nursing. 

The project began 

in 2009 when the 

faculty at the School 

of Nursing (SON) 

approved a vision 

statement which 

would lead them 

towards College 

status. The vision 

developed in 2009 

stated: “to be an 

internationally 

renowned college 

of nursing sought 

out by those who 

are committed to 

lifelong inquiry for 

improving the health 

of diverse populations.” The faculty and staff in the SON 

began work to develop fully functional doctoral programs and 

a successful trajectory of faculty research. 

The faculty set out to accomplish these goals. In 2012, 

the State Board of Education (SBOE) approved the PhD in 

Nursing and Doctor of Nursing Practice (DNP) - Family Nurse 

Practitioner (FNP) programs for the School. 

“With the growth of our programs it was time for it to move 

from the school to the college level. Becoming a College 

makes ISU the destination site to get a nursing degree,” Renn 

says. “We are proud to have the only PhD, only DNP - FNP, 

and the only DNP - Psych-Mental Health Nurse Practitioner 

(PMHNP) programs in the state.” Renn adds, “Here at the 

College of Nursing we have worked hard to get where we 

are today. The community’s support has played an important 

role in our success. Being a College means different things 

to different people, but it means progress for everyone in the 

School of Nursing.” 

Kevin McEwan, 

MSN, RN Voted 

to AONE Board of 

Directors 

Randall Hudspeth, PhD, MBA, MS, 

APRN-CNP, FAANP 

Executive Director, Idaho Center for 

Nursing 

Email: randhuds@msn.com 

Kevin McEwan, Chief Nursing Officer of 

Madison Memorial Hospital in Rexburg, Idaho, has 

been voted to a three year term on the Board of 

Directors of the American Organization of Nurse 

Executives (AONE) beginning in 2019. Kevin is an 

active member of Nurse Leaders of Idaho (NLI), 

which is the Idaho affiliate of the AONE. Kevin 

represents AONE/AHA Region 8, which includes 

New Mexico, Arizona, Colorado, Utah, Wyoming, 

Montana and Idaho. AONE provides leadership, 

professional development, advocacy and research 

to advance nursing practice and patient care, 

promote nursing leadership excellence and shape 

public policy for health care nationwide. Having a 

national board member from Idaho is an amazing 

opportunity for our Idaho nursing organizations 

to influence both the national nursing direction 

as well as health care policy. If you have areas of 

interest or concern that need a larger voice, please 

don’t hesitate to contact Kevin at kevin.mcewan@ 

mmhnet.org. 

NursingALD.com 

can point you right to that perfect 

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Idaho Association of Nurse Anesthetists (IDANA) Update 

Gus Powell, MSN, CRNA 

President, IDANA 

Email: guspowellcrna@gmail. 

com 

Since the inception of the 

Idaho Association of Nurse 

Anesthetists (IDANA) 63 years ago, 

the organization has grown and 

progressed a great deal. Recently, 

our association has taken strides 

to improve our infrastructure and 

Advocacy Requires Perseverance 

strategic planning. One area our Board of Directors focuses 

on is how we can better advocate for our members and 

profession. While we have had some wins with advocacy, the 

reality is that we are in a marathon, not a sprint. 

According to Merriam-Webster (2018), advocacy is 

defined as the act or process of supporting a cause or 

proposal. Advocacy as it relates to nurse anesthetists in 

Idaho can occur in almost every setting and with very diverse 

audiences. It can take place in an elevator with a member of 

the public, in the boardroom with an administrator, or in the 

Capitol with a legislator. The topics change over time, but it 

is our responsibility as advanced practice nurses (APRNs) to 

WORK-LIFE BLEND 

Come see for yourself. 

You BELONG here!! 

Expand Your Career 

Blue Mountain Hospital District, comprised of a Critical Access Hospital, Care Center 

Nursing Home, Home Health/Hospice, and Emergency Medical Services that serves 

the Grant County region. Located in beautiful eastern Oregon. We have an incredibly 

dedicated and dynamic team based environment. 

Currently Seeking 

• Experienced RN (Associate or BSN) – ER, OB, OR/Critical Care, Med Surg 

(Full-time, Part-time and Casual positions available) 

• RN, LPN/LVN and CNA (Intermediate Care Center/Nursing Home) 

• Physical Therapist (Outpatient/Home Health) 

• Director of Nursing Services (Intermediate Care Center/Nursing Home) 

• Occupational Therapist (Home Health & Outpatient) 

Best Benefits 

• Benefits include Retirement Plan with 

Employer Match 

• Generous PTO 

• Advancement Opportunities 

• Nursing Shift Differential 

• A lifestyle of enjoying the outdoors 

in a quiet, remote & rural community. 

“Quality Healthcare Close to Home” 

EOE/AA We support a tobacco free and drug free workplace. 

Seattle 

Portland 

Salem 

Eugene 

Bend 

Location 

John Day, Oregon 

Spokane 

John Day 

Boise 

advocate for our profession and our patients. We can’t assume 

that advocacy is only done by people in certain positions 

with specific titles. IDANA is no different than many other 

professional organizations. We are heavily dependent upon 

volunteers to do the work of the association, which includes 

running for office and board positions, as well as sitting on 

various committees. While these volunteers carry out the 

formal business and day-to-day practice of the association, all 

CRNAs have opportunities to advocate, which exponentially 

increases our professional footprint and impact around the 

state. 

Our focus as CRNAs and APRNs should consist of looking 

for new and creative ways to advocate and highlight our 

profession. This includes clinical and non-clinical partnerships. 

Often, we have situations where we face resistance and our 

goal seems distant, but it’s necessary to strive to maintain 

a positive attitude and offer solutions. Advocacy should not 

be a primarily reactive approach. Instead, advocacy should 

be proactive and assertive. New areas and relationships 

continually need to be explored. 

As an example of our advocacy efforts, IDANA has 

partnered with the Society for Opioid Free Anesthesia (SOFA) 

to increase awareness and resources regarding how we as 

anesthesia professionals can adapt to the current opioid crisis 

in our country. SOFA is a nonprofit organization with a goal to 

research, promote & educate anesthesia professionals and the 

general public on opioid free pain management techniques. 

They focus on promoting various anesthesia techniques with 

limited or no opioids. 

With our partnership, each member of IDANA received 

a year-long membership to SOFA, available at www. 

goopioidfree.com. This allows our members access to their 

database of research, information, and practical guides to 

practice. This commitment also includes hosting speakers 

at our educational conferences that discuss various ways to 

minimize opioids in our anesthetics and pain management 

practices, including lectures on maximizing the use of 

ultrasound guided nerve blocks and highlighting different 

enhanced recovery after surgery (ERAS) protocols. Although 

this single approach will not put an end to the opioid crisis in 

Idaho, we know it will increase awareness and information 

sharing in our profession. 

Finally, please mark your calendars for some important 

upcoming dates. IDANA is excited to be hosting our 2nd 

annual legislative reception on January 24th, followed by a 

day at the Capitol on January 25th. Also, our annual IDANA 

Spring meeting will be held in Boise on April 12th-14th at the 

Grove Hotel. We are excited to see advocacy in action at these 

upcoming events! 

Reference: 

Merriam-Webster (2018). Advocacy. Retrieved from https://www. 

merriamwebster.com/dictionary/advocacy?src=searchdict-box 

www.honoringchoicesidaho.org. 

Please call Human Resources for questions 

or more information at 541-575-3820 

Explore or Apply Online: 

www.bluemountainhospital.org


Human Simulation 

Lab at Idaho State 

University 

Lee Ann Hancock, Director of Divisional 

Marketing & Communications 

Lindsay Taylor, College of 

Nursing Career Path Intern 

Email: hanclee@isu.edu 

Faculty and leadership in the College of Nursing at 

Idaho State University find it very important that the nursing 

students get the best possible education and training. When 

the nursing students are going through training, they work 

with each other, instructors, and high-fidelity manikins in the 

Human Simulation lab to learn their skills. 

The fourteen high-fidelity manikins are called Meti men 

and they allow students to identify a pulse, heart, lung and 

bowel sounds. Their eyes can dilate or constrict according 

to the light, they can blink, and there is a microphone in 

them so an instructor can respond to the nursing students’ 

questions. Meti men help provide real life situations that 

allow the students to gain experience before they go out into 

a hospital, nursing home, or a doctor’s office. Chris Smout, 

the simulation lab coordinator says, “I’m a nurse and I came 

from the ICU and there isn’t anything I haven’t been able to 

do on a patient in the ICU that I wasn’t able to do on these 

Meti men, so it allows us a lot of liberty with what we do with 

our simulators.” 

Before these students can go out into clinical settings, 

they have to learn their assessments by working with each 

other and some of the manikins that are low fidelity. Once 

they have learned all of their skills, they can start doing 

simulations on the Meti men to get a more real life situation. 

Before the students can start their clinicals, they have to go 

through several different tests to check their knowledge and 

understanding of their skills. The lab allows the students to 

perfect their skills in a safe environment. 

“When they are first starting the program, they are 

practicing on each other, so we can give them the basic 

skills and let them practice it in a safe environment. Then 

as they get a little further on, we throw in simulators using 

our high-fidelity manikins. Occasionally, they will bring in a 

standardized patient which is someone they don’t know, 

and they will pretend to be their patient. This is mostly 

with the Doctorate of Nursing Practice program not the 

undergraduate programs,” said Smout. 

In the lab, they are always working on refining their 

simulations to provide the best experience for the student 

nurses. Smout is always working to make the lab run more 

effectively, and efficiently. The lab is constantly buying new 

equipment to stay up-to-date with the surrounding hospitals 

to make sure the students are getting exposure to anything 

they could possibly encounter. Some of the equipment they 

have includes a medication cart, which is what they use in 

almost every healthcare setting, and an electronic charting 

system so the students can become more familiarized with 

how to chart correctly. There are also task trainers such 

as IV arms or tracheostomy models that allow students to 

perform specific tasks multiple times. The university just 

purchased a new Zoll defibrillator as well. 

The simulation lab allows the students to learn their 

skills in a safe but realistic environment. Being able to learn 

these skills before going into a real-world setting helps the 

students be more prepared and know how to properly 

assess their patients. “It made me super nervous to have 

to do the simulations, but I learned a lot from them. I liked 

the sims because it makes you critically think and then 

take action,” said Kenzie Swafford, a graduate from the 

Bachelors of Nursing program. There are many different 

situations and settings they can run with these simulations 

such as being in the emergency room, a doctor’s office 

or on a medical-surgical floor. The simulation lab is an 

important part of the learning experience for undergraduate 

and graduate nursing students. 

Students Shine at Lewis-Clark State 

College Nursing Symposium 

By Sydney Parker, MSN, RNC-OB 

Assistant Professor, Lewis-Clark State College 

Email: separker@lcsc.edu 

On December 6, 2018, 50 senior nursing students 

at Lewis-Clark State College in Lewiston, ID had the 

opportunity to share evidence-based practice (EBP) projects 

with faculty, students, and clinical agency representatives 

at the Fall Nursing Symposium. Projects ranged from best 

pain management practices in the emergency department 

to stroke recognition and education in the community. 

Students shared their projects in conference-style 

presentations, complete with posters and a “Question and 

Answer” session. 

The EBP projects were a culmination of two semesters 

of work in collaboration with their Community Health 

course. In addition to the traditional EBP process, students 

also had the opportunity to submit self-designed surveys 

to the Institutional Review Board (IRB) and to design 

interventions based on survey results, which they shared 

during Symposium. Students report that they hope to 

further disseminate their projects following graduation and to 

eventually implement their interventions with key stakeholder 

support. “We hope that students will understand not only 

the process, but also the importance of evidence-based 

practice and their role in it as a BSN-prepared nurse in 

the workplace,” stated Sydney Parker, their lead course 

instructor. 

The next cohort of students have begun preparations 

for their EBP projects and will present at the all campus 

Symposium on May 2nd at Lewis-Clark State College. All 

those interested in observing the presentations are invited to 

attend. 

Pictured (left to right): LCSC nursing students Monica Montero, Shannon Bay, and Virginia Ixta present 

their EBP project at the Fall Nursing Symposium. 

Pictured (left to right): LCSC senior nursing students Julia Platt, Hannah DeLay, and Johanna Ponce 

answer faculty and student questions at the Question and Answer session following Symposium. 

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RN Idaho is pleased to honor deceased 

registered nurses and licensed practical 

nurses who graduated from Idaho nursing 

programs and/or served in Idaho during 

their nursing careers. Included, when known 

from a published obituary or when space 

allows, will be the date when deceased and 

the Idaho nursing program. 

The names will be submitted to the 

American Nurses Association for inclusion 

in memoriam held in conjunction with the 

ANA House of Delegates. Please enable 

the list’s inclusiveness by submitting 

information to rnidaho@idahonurses.org. 

Bowman, Rodonna, 1924-2018. She 

attended LPN training in Idaho Falls and worked 

at LDS Hospital in Idaho Falls. 

Brower, Randall Mark, 1950-2018. He was 

tender-hearted and worked hard to provide for his 

family. He was a nurse by profession, caring for 

many. 

Carlson, Mary Troy, 1937-2018. She earned 

her LPN degree from VoTech and worked in the 

newborn nursery at Madison Memorial Hospital, 

where she cared for many of her grandchildren 

during their first hours of life. She finished her 

career in Central Sterile Processing. 

Chadwick, Karin Marie, 1955-2018. Karin 

attended UC Davis and Idaho State University. 

She received a Master’s degree and was a very 

competent nurse in the Emergency Department at 

Pocatello Regional, where she became Director of 

Nursing. 

Childers, Linda Jane, 1947-2018. Linda 

attended Boise State College where she earned 

her Associate Degree in Nursing in 1969. Linda 

worked at Mercy Medical Center from 1969 until 

she retired in 2007. She was involved in over 

10,000 births in her 38 year career. To honor her 

dedication, Saint Alphonsus in Nampa dedicated 

a birthing room in her name in and they refer to 

it as a “womb with a view,” as it overlooks the 

Centennial Golf Course. 

Clark, Paula Marie Ritzman, 1939-2018. 

Paula was born in Pocatello and attended Holy 

Cross Nursing School in Salt Lake City. She 

worked at St. Anthony’s Hospital, Pocatello, and 

went on to work as a nurse in Utah, Tennessee, 

and California. 

Eisenbeis, Debra Rose, 1955-2018. Debi 

graduated from the LPN program at Boise State 

University. She worked as a nurse in a wide 

variety of medical settings for more than 30 years. 

Felde, Jeffery James, 1978-2018. Jeff 

served in the United States Air Force in the 68th 

Unit from 2002 to 2008. He proudly served in 

both Operation Iraqi Freedom and Enduring 

Freedom. After honorably discharging as a Staff 

Sergeant, he attended Idaho State University 

where he received his BSN. He worked as an 

RN for Heritage Home Health in Pocatello. The 

care and compassion he had for his patients was 

tireless, and he was adored by them in return. 

Gaertner, Carol, 1938-2018. She was a 

professional model for the Crescent Stores in 

Spokane before finding her life’s calling as a 

nurse. She retired from Saint Alphonsus in Boise 

in 2008. 

Galarza, Marjorie, 1924-2018. Marjorie 

graduated from Boise Junior College School of 

Nursing in 1962. She later worked for Mercy, St. 

Alphonsus, St. Luke’s, and Caldwell Memorial 

Hospitals. 

Gordy, Frances, 1920-2018. Frances became 

an LPN at the Caldwell Memorial Hospital. She 

enjoyed many proud years as an OB nurse and 

helped countless lives in the nursery. Even in 

retirement, she continued caring for others in 

home health and volunteer work. 

Hugg, Dorothy Ann Fackler, 1940-2018. 

She received her LPN degree from St. Luke’s 

Hospital School of Nursing and Boise Junior 

College in 1959. She returned to school two more 

times to receive an Associate RN degree and a 

BSN at Weber State University. She practiced 

nursing in Oklahoma, Washington, Utah and 

Idaho in Medical/Surgical, ICU, Endoscopy, and 

Home Nursing for years. 

Kersey, Dorothy Alice, 1930-2018. Dorothy 

worked at the old St. Alphonsus Hospital in 

downtown Boise. She later helped open Boise 

Convalescent Center as Director of Nursing, and 

also worked at Grand Oaks Nursing Home as 

Director of Nursing. She then joined the Boise 

School District, teaching Health Occupations. 

Dorothy then spent 12 years with the Meridian 

School District as a school nurse. 

Langford-Vance, Lillie Marie, 1938-2018. 

She returned to school after her family was 

raised, obtaining her BSN from Boise State 

University in 1992. She worked in hospitals and 

elderly care before retiring in 2009. 

Macdonald, Mary Louise “Mimi”, 1949- 

2018. She was a founding leader of the Pocatello 

chapter of La Leche League International. Her 

passion for helping mothers and infants continued 

for almost 20 years in this role. Mimi worked as 

a nurse, spending the last two decades of her 

career as a research study coordinator with ISU 

Family Medicine. 

Pahl, Frieda Justina, 1936-2018. She 

attended school in American Falls and furthered 

her education at St. Anthony’s Hospital, where 

she became an RN in 1958. She worked at St. 

Anthony’s Hospital in Pocatello and Power County 

Hospital in American Falls. 

Pecher, Thelma May, 1929-2018. Thelma 

was born in Twin Falls. She graduated from 

Kimberly High School in 1947 and the College of 

Southern Idaho in 1972 from the LPN program. 

Ray, Carolyn, 1930-2018. She achieved the 

Practical Nurse Training Certificate from Idaho 

State University LPN Program and St. Anthony 

Community Hospital in 1969. She was a charge 

nurse while employed at Bannock Nursing 

Home. Education was so important to her that 

she encouraged and provided opportunities for 

coworkers to obtain their career goals as well. 

Ray, Laura Mary Mathews, 1930-2018. She 

attended nursing school at Riverview Hospital 

in Idaho Falls. Her skills as a nurse were highly 

respected and she was sought after for her gifts 

to the nursing field. She was selected to start up 

the Intensive Care Unit as well as the Nursery 

Intensive Care Unit at Parkview and Riverview 

Hospitals. 

Reeves, Julia Lee, 1934-2018. Julia 

graduated in 1953 from St. Luke’s Hospital and 

worked in hospitals around the Treasure Valley, 

including Mercy Hospital and the Idaho State 

School and Hospital. 

Smith, Ada Kathryn Jones, 1926-2018. She 

graduated from Ricks College with an Associate 

Degree in nursing. She spent many years 

working at the Caribou Memorial Hospital in Soda 

Springs. In 1970, she returned to Idaho State 

University and obtained her BSN. 

Smith, Ellen Myrdean Roseborough, 1933- 

2018. Myrdean spent most of her career working 

as a nurse at Ashton Hospital, Madison Memorial 

Hospital, and District 7 Health office. 

Stewart, Opal Waive Turnidge Clapp, 1927- 

2018. Opal graduated from St. Luke’s Hospital 

School of Nursing. She worked labor and delivery 

for many years before returning to school at 

the University of Arkansas to become a Nurse 

Practitioner. She became one of Idaho’s first 

Certified Registered Nurse Practitioners. 

Stokes, Katheryne, 1921-2018. She became 

an LPN in 1962, retiring after 20 years in 1983. 

Tuller, Anna Jean, 1925-2018. Jean 

graduated from St. Luke’s Hospital School of 

Nursing in 1948. After her husband graduated, 

they returned to Boise where she worked as 

a surgery and obstetrics nurse at St. Luke’s 

Hospital. Later, Jean worked at Saint Alphonsus 

Hospital as a float nurse. 

VanLeuven, JoAnne, 1940-2018. JoAnne 

went to Ricks College and Carroll College to 

obtain her RN license. Later, she attended Idaho 

State University and received a BSN. She worked 

at Bannock Hospital in Pocatello for many years 

as a cancer nurse and retired in 2002. 

Warner, Margaret Wilmoth Reay, 1940- 

2018. She graduated from Idaho State College 

with her certificate in practical nursing. She 

worked as an LPN for the remainder of her life. 

Wells, Doreen Alleman Hibbert, 1926-2018. 

Doreen attended the nursing program at the LDS 

Hospital in Idaho Falls through the Cadet Nursing 

Program during WWII. Afterwards she received 

her pediatric nursing training in Springfield, 

Illinois. She worked for 23 years as pediatric night 

nurse at Bannock Memorial Hospital in Pocatello. 

Whiting, Jon Myrtle Innes, 1937-2018. After 

her family was raised, she enrolled in the LPN 

program at St. Anthony’s Hospital. She worked 

exceptionally hard to earn the right to wear her 

nurse’s cap and did so proudly. Her nursing 

career spanned more than 30 years. 

Zohner, Marivene Amelia List, 1953-2018. 

She enjoyed her work as a nurse, focused in the 

Neonatal ICU in multiple locations including Idaho 

Falls, and Provo and Orem, Utah.


UPDATE FROM THE BOARD OF NURSING 

Sandra Evans, Executive Director 

Idaho Board of Nursing 

Email: sandra.evans@ibn.idaho.gov 

The Idaho Board of Nursing continuously strives to remain relevant by a sustained 

awareness of and responsiveness to changes in the healthcare and regulatory 

environments. To this end, each quarter Board members identify and discuss current state, 

national and global issues and evolving trends that do or may in the future impact the work 

of the Idaho Board. These ongoing generative conversations assist the Board in knowing 

what’s coming our way and the impact these trends may have on the regulation of nursing 

practice and education in Idaho, the U.S. and around the world. 

At their meeting on November 1-2, 2018, the Board identified the following issues/trends 

of significance: 

Goal Initiative 

Licensure 

Issues/Trends 

• Nationwide bi-partisan political movement toward 

deregulation of occupations in an effort to reduce barriers 

to employment 

• Support for regulatory options to enhance license 

portability (e.g. licensure compacts) 

• International efforts to address the need for more nurses, 

including strategies to credential refugee nurses who 

are unable to access primary source documents due to 

geopolitical turmoil in their countries of origin 

• Accepted reports and recommendations from the Board’s APRN and PRN Advisory 

Committees; 

• Took formal action to revoke the licenses of two LPNs based on determination of 

violations of provisions of the Nursing Practice Act and Administrative Rules of the Board; 

• Following a contested case hearing before the Board during which arguments on both 

sides were presented, the Board took action to revoke the RN and APRN, CNP licenses 

of a nurse based on determination of violations of provisions of the Nursing Practice Act 

and Administrative Rules of the Board; 

• Granted full approval for the eight year period ending 2026 to the practical nursing 

education program proposed for implementation by the College of Western Idaho; and 

• Granted full continuing approval for the eight year period ending 2026 to practical nursing 

program administered by the College of Technology, Idaho State University. 

Meetings of the Board are generally held in Boise at locations to be announced prior to the 

meeting and include an “Open Forum” on the second morning of each meeting. During the open 

forum, the public is provided the opportunity to dialogue with the Board on issues of interest 

that are not necessarily included on the published agenda. The Board will not take action on 

issues introduced during the forum, but may choose to address them at a later scheduled Board 

meeting. 

As always, the Board welcomes your comments and suggestions and invites the public to 

attend all or portions of scheduled meetings of the Board. For further information, visit the Board’s 

website or contact the Board office at 208.577.2476. 

Practice 

Education 

Discipline 

Communications 

• International support for needs-based designated nurse 

staffing levels 

• Support for use of non-licensed community health 

workers as a way to reduce hospitalizations and/or 

emergency room visits 

• Guidelines for the use of medical marijuana for patients, 

care givers, and prescribers that may impact aging 

practitioners 

• Evidence of age-associated cognitive changes and their 

effects on work performance 

• Emerging/evolving practices and increased blurring of 

roles between professions (e.g. RN prescribing authority 

in Canada, aesthetic procedures, etc.) 

• More nurses pursuing higher levels of education than 

ever before (e.g. 180% increase in the number of nurses 

completing RN-to-BSN programs from 2010 to 2017) 

• Increased enrollment in Doctor of Nursing Practice 

programs over previous years 

• Legislative movement toward decriminalization of certain 

crimes for licensure and disciplinary purposes (e.g. 

decriminalizing misdemeanor crimes unless directly 

related to nursing practice) 

• Substance use disorder among nurses as part of the 

national opioid abuse epidemic and strategies to support 

nurses in their return to safe practice 

• More people worldwide communicating directly on a 

computer network rather than face-to-face, impacting 

organizational communication processes 

• Ethical issues surrounding communication within 

organizations as a growing concern (e.g. patient 

confidentiality violations, right to privacy concerns, 

employer rights) 

• Cybersecurity threats 

In addition to the above, the Board accomplished new and continuing routine business 

related to their primary strategic goals at their November 2018 meeting. Board members 

Vicki Allen, RN, Pocatello, Chair; Carrie Nutsch, LPN, Jerome, Vice Chair; Jennifer Hines- 

Josephson, RN, Rathdrum; Whitney Hunter, Consumer, Boise; Jan Moseley, RN, Coeur 

d’Alene; Rebecca Reese, LPN, Post Falls; Clay Sanders, APRN, CRNA, Boise; Merrilee 

Stevenson, RN, Wendell; and Reneé Watson, RN, Boise: 

• Reviewed correspondence and reports of external meetings attended by Board members 

and staff, including the National Council of State Boards of Nursing (NCSBN) 2018 Annual 

Meeting and Delegate Assembly in Minneapolis, MN August 15-18; the 2018 Citizen 

Advocacy Center (CAC) Annual Meeting in Washington, DC, October 16-17; meetings of 

the Nurse Licensure Compact Interstate Commission in Minneapolis, August 14 and by 

teleconference October 9; 2018 biennial International Nurse Collaborative Symposium in 

Chicago, October 22-23; and NCSBN Scientific Symposium in Chicago, October 24; 

• Reviewed administrative rules proposed at their July 2018 meeting and unanimously 

adopted them as “pending” for consideration by the 2019 Idaho Legislature. The pending 

rules, for which no public comments were received during the designated comment period 

following their initial publication, address: 

° ° Changes in required criteria for APRN prescriptions; and 

° ° Clarification of the approval term for nurse apprentices following graduation from their 

nursing education programs; 

• Appointed Zach Morarity, MD, Twin Falls and Ralene Wiberg, MD, Boise to three year terms 

on the Board’s APRN Advisory Committee; 

• Appointed Heather Naskar, APRN-CRNA, Middleton; Susie Bunt, RN, Lewiston; Jill 

Humble, RN, Boise; and Susan “Spooky” Taft, Consumer, Ketchum to three year terms on 

the Board’s Program for Recovering Nurses (PRN) Advisory Committee;



Prescribing continued from page 7 

The Opioid Discussion 

Behavioral health comorbidities such as post-traumatic 

stress disorder (PTSD), depression, bipolar disorder, and 

other health conditions correlate with a higher incidence of 

opioid use disorder (OUD) (Proctor, 2013). Musculoskeletal 

pain combined with PTSD makes the patient at higher 

risk for misuse, abuse and addiction (Bilevicius, Sommer, 

Asmundson, & El-Gabalawy, 2018). The provider should 

know the chronic pain conditions for which opioids are not 

the recommended treatment. 

Clues to Misuse, Abuse, Tolerance, Dependence, 

Pseudo-addiction, or Addiction 

Evaluation for client misuse, abuse, tolerance, dependence, 

pseudo-addiction, or addiction to opioids is an ongoing 

component of risk mitigation (Meltzer, Rybin, Saitz, 

Samet, Schwartz, Butler, & Liebschutz, 2011). Clues 

include: multiple requests for early refills; reports of lost or 

stolen medication; request for dose escalation; provider 

shopping; patients coming from a long distance to your 

clinic; or bringing older records to corroborate prior opioid 

prescriptions (Lawrence, Mogford, & Colvin, 2017; Hoffman, 

2017). Other clues include: receiving multiple prescriptions 

from different pharmacies; positive urine drug screening for 

other substances, or screening not positive for prescribed 

opioid; or missing follow-up appointments and/or UTOX 

(Meltzer et al., 2011). 

Conclusion 

In conclusion, risk mitigation includes establishing 

treatment goals with your patient prior to prescribing. A goal 

should be to use opioids to improve functional capacity, not 

eradicate pain. Providers need to discuss and reinforce the 

risks and benefits of therapy. For non-cancer— acute pain— 

prescribe opioid pain medication for a duration of three 

days, utilizing immediate-release opioid formulations. For 

chronic pain, nonpharmacologic and nonopioid therapies 

are preferred. If there is no functional improvement within 

four to six weeks, discontinue therapy (Frieden & Houry, 

2016). 

Motivational Interviewing Techniques are effective 

communication tools to explore/acknowledge the patient’s 

beliefs about their pain experience, including anxiety and 

fear of pain (S. Pote, personal communication, November 

2018). Prescribers should explore the presence or history 

of previous or current substance use disorders, as well as 

the chronic use of such substances as alcohol, marijuana, 

recreational drugs, and the use of non-prescription or 

borrowed medications. 

Pain is a complex entity that is intertwined within the 

human condition. The experience of pain is individual 

and laced with social, physical, and psychological comorbidities 

and emotional distress. Faithful employment of 

risk mitigation practices in the prescribing of opioids for noncancer 

pain protects the patient, the community and your 

practice. 

References 

Ahmad, F. B., Sutton, L. M., Spencer, M. R., Warner, M., & Sutton, 

P. (2018). Provisional drug overdose counts. Retrieved 

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IALN AND NLI UPDATES 

Karen Neill, PhD, RN, SANE-A, DF-IAFN 

President, NLI and IALN 

Email: neilkare@isu.edu 

The Board of Directors of both Nurse Leaders of Idaho 

(NLI) and Idaho Alliance of Leaders in Nursing (IALN) 

are looking forward to another successful year. The year 

2018 brought significant changes to both organizations 

by increasing influence on public policy and the future 

of nursing in Idaho. With the knowledge that Idaho is 

facing the largest nursing shortage in its history within 

the next five years, as well as understanding the impact 

of recognition in the workplace and support for nursing 

education on retaining the workforce, the organization’s 

activities have focused on these opportunities. 

Communication is essential and NLI and IALN are 

determined to continually improve how nurses in Idaho can 

receive and access information and educational alerts. RN 

Idaho underwent a big change when the sponsorship was 

changed from its long-standing relationship with ANA-Idaho 

(formerly the Idaho Nurses Association) and moved to 

IALN and the Idaho Center for Nursing. This move helped 

maintain the financial viability of the publication and altered 

its focus to be on all nursing organizations in Idaho and on 

the importance of nurse recognition in general. 

To ease online communications, NLI, IALN, and the 

Nursing Action Coalition established a new website that is 

hosted through Nursing Networks. This is the same host 

that ANA-Idaho, the School Nurses of Idaho, and Nurse 

Practitioners of Idaho use. The layout and navigation 

systems are the same, so it is easier for nurses to move 

between these websites. This allows the association to 

maintain easy control over posting announcements and 

events. Similar to RN Idaho, the website can be used by 

non-members who select to follow organizational activities 

and connect with partners (see announcement on how to 

“Follow Your Organization.”) 

NLI and IALN programs also support an educated 

and sustained nursing workforce. A major contribution 

to understanding the current nursing workforce issues 

was the data collection and analysis of the 2018 Nursing 

Workforce Report. This is a biennial study that is completed 

in collaboration with the Idaho Board of Nursing, Idaho 

Hospital Association, Idaho Healthcare Association, 

Home Health and Hospice, Public Health and all nursing 

education programs in the state. The data is analyzed by 

nurses who understand the nuances of the profession 

and its practice and nursing supply implications. The 

data is available on the NLI website and has been widely 

distributed within the state to healthcare institutions, 

legislators, and education facilities. 

Understanding and supporting the recognition of nurses 

in the workplace is an important aspect of workforce 

satisfaction. NLI is again planning to host the annual “Nurse 

Celebration and Recognition Dinner” in conjunction with the 

Fall 2019 conference. Any healthcare agency that employs 

nurses and has recognized them for their contributions, is 

encouraged to participate and have their staff recognized 

on a statewide basis. 

The nursing organizations in Idaho are strong and wellpositioned 

to impact nursing practice within the state. The 

NLI/IALN Board of Directors looks forward to the continued 

success of RN Idaho, the nursing educational offerings 

within the state, and the success of each individual nursing 

organization as a part of the Idaho Center for Nursing. 

Program for 

Recovering Nurses 

Addiction Intervention and Recovery Services 

for Nursing Professionals 

Do you know a nurse or a colleague who needs help for 

drugs/alcohol or mental health problems? 

Please contact us for assistance. This program is an 

alternative to disciplinary action offered by the BON. 

For immediate assistance, please call us at 800-386-1695 

www.southworthassociates.net


American Nurses Association/ ANA Idaho Membership – 

It’s Your Choice! It’s Your Privilege! 

Just Because You Received This Publication, 

Doesn’t Mean You Are an ANA Idaho Member

Correctional care. 

Committed careers. 

Now hiring! 

(Throughout the state of Idaho) 

Registered Nurses 

Licensed Practical Nurses 

Correctional Medical Specialists 

Contact Jocelyn Lee | jocelyn.lee@CorizonHealth.com | (615) 660-6806

RN Idaho - February 2019

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