The Official Publication of the Virginia Nurses Foundation
February 2020 Quarterly publication direct mailed to approximately 107,000 Registered Nurses
Volume 28 • No. 1
We are pleased to provide every registered nurse in Virginia with a copy of Virginia Nurses Today.
For more information on the benefits of membership in of the Virginia Nurses Association,
please visit www.virginianurses.com!
Social Determinants of Health
Honor a Nurse
Call for Applications: Mental
Health First Aid Training
Nightingale Legacy Fund
Pages 12-13 Page 14
During Patient Safety
Week in March
Nancy Littlefield, DNP, RN
Across the nation and
Virginia, health systems will
recognize “Patient Safety
Awareness” Week, March
8-14. It’s a week set aside
to recognize current work
and also have heightened
awareness of the importance
of patient safety across the
We have come a long way since 1999 when the Institute
of Medicine’s Report “To Err is Human: Building a Safer
Health System” was published. A definition of patient
safety emerged from the literature as “the prevention
of harm.” There was an emphasis on the processes of
healthcare delivery to prevent errors and, if an error
did occur, we were encouraged to stand up to ensure
the culture was fair and just so there could be real learning. In the last decade,
healthcare facilities have fine-tuned bar code scanning, two patient identifiers, “speak
up” campaigns, patient family advisory groups, and Patient/Family Rapid Response
activation when things don’t look just right—all to keep patients at the center of all we
do and to “do no harm.”
Electronic Medical Records, medication dispensing systems, and telehealth
to monitor high risk patients are examples of how health systems have invested
in technology to minimize opportunities for human error. While each technology
advancement is important, it cannot replace the importance of strong relationships
between the patient and the healthcare team and between team members. Strong
relationships across the care continuum help support a culture of speaking up and
patient advocacy, a culture where nurses are recognized when they speak up about a
pre-procedure time out that isn’t complete or when a warm hand off between levels of
care is forgotten.
Each of us has an important role in fostering strong relationships in support of a
culture of safety. Healthcare professionals must strengthen our own competency and
confidence as we understand the power and the value of being present for our patients,
listening for what others can’t hear and speaking up when others don’t have words.
As you recognize Patient Safety Week, take a moment and recognize all that you do for
the “prevention of harm.” It’s more than the thousand processes we keep up with and the
technology that supports our work. It’s about you and the work you do every day to blend
art and science.
current resident or
U.S. Postage Paid
Permit No. 14
as you show up
knowing it matters.
Be the example
and mentor to
those learning and
“The very first
requirement – is
that we should do
the sick no harm.”
Black History Month
2020: A Reflection
on Voting Rights for
Vivienne Pierce McDaniel,
VNA and VNF Diversity,
Equity, and Inclusion
VNF Diversity, Equity, and
The theme for this year’s
Black History Month (BHM)
is “African Americans and
the Vote.” The year 2020
is a milestone for voting rights in America because
it is the 150th anniversary of the 15th Amendment,
which gave African American men the right to vote
following the Civil War. Coincidentally, it is also the
centennial of the 19th Amendment and the pinnacle
of the women’s suffrage movement.
The 15th Amendment, which was ratified in 1870, recognized the rights of
citizens of the United States to vote regardless of their race, color, or previous
condition of servitude, but it would take another 50 years (1920) for Congress
and the states to ratify the 19th Amendment, acknowledging the suffrage
rights of women (National Park Service, 2019). It’s important to remember that
the right to vote did not always result in an opportunity to vote during that era.
Discriminatory practices continued to be used to prevent African Americans from
exercising their right to vote, although President Lyndon B. Johnson signed the
Voting Rights Act (VRA) in 1965.
During the month of February 2020, many BHM programs will consist of
plays that reenact the historical Selma march and other campaigns that led to
President Johnson’s signing of the VRA of 1965. Other programs will feature
speakers who will use their platform to recall their personal experiences
regarding injustice, inequality, and the fundamental constitutional right to vote.
For this article, I engaged civil rights activist Congressman John Lewis (GA-
5), and Virginia Senators L. Louise Lucas (VA-18) and Mamie Locke (VA-2) in
personal conversations about voting rights.
Most of us who have “grown up” in America have learned one of the most
effective ways that we can
influence legislative decisionmaking
is through voting.
Senator Lucas opines that
despite the 15th and 19th
voting, most specifically in
the south, was “grossly and
intentionally suppressed from
1890 to 1965.” According
to Senator Lucas, voter
suppression has carried on into
the 21st century and continues
to be a problem.
Black History Month
continued on page 2
Senators Mamie Locke and Louise Lucas
during General Assembly 2019
Page 2 | February, March, April 2020
Virginia Nurses Today | www.VirginiaNurses.com
Black History Month continued from page 1
In a similar conversation with Senator Mamie
Locke, she expressed discontent in past and
current voting practices. Senator Locke said, “there
is no reason to make it difficult for individuals to
exercise their right to vote; it definitely should not be
happening in this century.” “As Americans, it is our
duty to ensure that anyone who is eligible to register
and vote be allowed to exercise their given right to do
so without obstruction,” stated Senator Locke.
When I met with Congressman John Lewis I
wanted to know what it was like on the Edmund
Pettus Bridge in Selma, Alabama on March 7, 1965,
particularly when the nonviolent protesters were
met with brute force opposition that included state
troopers brandishing nightsticks, tear gas and
whips. Congressman Lewis vividly accounts the
day he and the other protesters marched for the
voting rights of those denied the right to vote. The
details are graphic and will not be discussed here,
but Congressman Lewis said he feared that he
would “die on that bridge.” Congressman Lewis said,
“When I was being beat on that bridge, I thought I
would lose my life right there, but it would not have
been in vain.” The congressman emphasized the
significance of voting and having your vote count.
“It is imperative that citizens remain vigilant, stay
informed about changes in legislation, and most
importantly, exercise their right to vote,” says
I would be remiss if I did not acknowledge civil
rights activist Mary Eliza Mahoney, the first African
American to complete nurse’s training in 1879. Miss
Mahoney is also credited as one of the first women
to register to vote in her state of Massachusetts
following ratification of the 19th Amendment (Spring,
2017). Senator Lucas said she imagines that many
African Americans were feeling euphoric thinking
that the amendment was a quick fix to the ongoing
issues of voting rights, only to learn that barriers
such as poll taxes continued to exist. Mahoney, along
with many African American women such as Ida B.
Wells, Nannie Helen Burroughs, Josephine St. Pierre
Congressman John Lewis and Dr. McDaniel discuss
his participation in the 1965 March to Selma
Ruffin, and Mary McLeod Bethune led civil rights
organizations that contributed to the VRA of 1965
(National Park Service, 2019).
There are too many nuances surrounding the
African American suffrage movement to discuss
here, but perhaps your curiosity and propensity
for gaining new knowledge will lead you to further
investigate. And remember, you should never take
your constitutional right to vote for granted. You
must always seek ways to ensure that you are
allowed the opportunity to exercise that right. Happy
Black History Month!
*The Virginia Senate recently named Sen. L.
Louise Lucas (D-Portsmouth) as president pro
tempore, making her the first woman and first
African American to hold the chamber’s secondhighest
office. Senator Mamie Locke was the first
African American mayor of Hampton, VA.
National Park Service (2019). Series: Suffrage in America:
The 15th and 19th Amendments. Retrieved from https://
Spring, K. A. (2017). Mary Eliza Mahoney. The National
Women’s History Museum. Retrieved from https://www.
is the official publication of the Virginia Nurses
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Kristin Jimison, Managing Editor
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www.VirginiaNurses.com | Virginia Nurses Today February, March, April 2020 | Page 3
As of May 2020 only members of Virginia Nurses Association will
receive a print copy of Virginia Nurses Today.
If you are not a member of Virginia Nurses Association,
look for the next issue in your email inbox! To be sure to receive your free
digital copy, subscribe online at https://tinyurl.com/VNTGreen.
We are excited to announce that Virginia Nurses Today is going GREEN!
Beginning with the May 2020 issue, the publication will be distributed as
part of a Virginia Nurses Association membership benefit in both printed and
electronic form, and it will be available as an electronic publication to nonmembers.
We encourage every nurse in Virginia to register to receive Virginia Nurses
Today publication electronically. Whether you want to go green, or just like
reading it electronically, signing up for the online version of Virginia Nurses
Today is super easy. It will be in your inbox faster than standard mail!
Register your email now and sign up to receive Virginia Nurses Today
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Page 4 | February, March, April 2020
VNF President's Message
Virginia Nurses Today | www.VirginiaNurses.com
Addressing Virginia’s Bed Shortage and Other
Challenges to Mental Healthcare Delivery
The Virginia Nurses Foundation’s Mental Health
Roundtable continues to identify, explore and focus
on the difficulties and challenges of providing mental
healthcare to a large population of Virginians,
inclusive of all ages, genders, ethnic groups and
nationalities. The Roundtable meets quarterly and
includes, in addition to nurses, behavioral health
professionals, law enforcement, legislators and
any other interested individuals and stakeholder
groups. Three Roundtable workgroups have evolved:
1) Stigma, 2) Integrated/Interdisciplinary Care, and
3) Access, Availability and Appropriateness of Care,
and all concur that there are significant issues
surrounding availability of beds and staff to care
for patients suffering from mental/behavioral health
Speaking at a recent meeting of the Roundtable,
VHHA (Virginia Hospital & Healthcare Association)
Director of Intergovernmental Affairs Jennifer Wicker
indicated that the shortage of beds for individuals
dealing with mental health issues is not new but
has been a constant challenge. This, she suggests,
is more likely a result of an insufficient investment
in the system that is far more reactionary than
proactively planning. Wicker shared with the
group that from 2015 to 2018, hospital admissions
increased by approximately 5,000, but that 4,000
of those admissions were voluntary across not only
psychiatric hospitals but community hospitals,
as well. Unfortunately, individuals of all ages who
are seeking mental healthcare end up retained in
emergency rooms that generally are ill-prepared to
care for patients long-term while waiting for a mental
The concern about access and availability of
care identified by the Roundtable appears to be
validated in a recent article in the Virginia Mercury
by Robert Zullo who concurred with Wicker. He
states that “involuntary admissions to state mental
hospitals are spiking” and this is happening at a
time when beds are not available for the number
of patients seeking care. Zulo further writes that
hospitals are “not properly staffed,” echoing a report
by the state inspector which states “more than half
of the hospitals were not properly staffed.” The
Inspector General report also seemed to confirm
other challenges identified by both the Access &
Availability of Care and Interdisciplinary/Integrated
Care Workgroups that due to “an increase in certain
patient populations and the staff turnover at
facilities, more personnel are being asked to care for
patients for which they have not received training.”
Interestingly, Wicker echoed these concerns when
she shared challenges of bed issues and shortages
of certain patient groups with the Mental Health
Roundtable. She specifically identified the lack of
resources in the system to deal with the aggressive,
substance abusing, and geriatric patients requiring
extensive stays in the emergency room setting
while seeking a bed and
resources that will be able
to care for the patient.
The shortage of beds
does seem secondary to the lack of staff who have
the knowledge, skills and credentials to work with
individuals seeking mental healthcare. According
to the Inspector General as documented in Zullo’s
article, “Not having staff members cross-trained
puts the employee and the patient at risk for not
effectively providing and receiving the patientspecific
care needed.” These are also major
workforce issues identified by the Stigma and
Interdisciplinary/Integrated Care Workgroup of our
Mental Health Roundtable.
What has been made obvious are the challenges
and the work left to be done to provide the
appropriate care and treatment to individuals
seeking mental healthcare. Clearly the Governor’s
Office and Virginia’s legislators understand and
share the concern for not only the bed shortage
issues but the appropriate staff knowledge, care
and resource issues. The next meeting of the Mental
Health Roundtable will be held Friday, February
28 and will focus on mental healthcare versus
incarceration and while incarcerated. Please contact
VNA/VNF CEO Janet Wall at jwall@virginianurses.
com if you are interested in attending and/or
working with any of the workgroups.
Zullo, Robert. Report: As Admissions Surge, Some State
Mental Hospitals Are Understaffed, Lack Overtime
Policies. 18 Nov. 2019, https://www.virginiamercury.
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To learn more, contact Teri Dulong-Rae at
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Thanks to the Virginia legislature for making this program possible.
www.VirginiaNurses.com | Virginia Nurses Today February, March, April 2020 | Page 5
Nursing Collaborative Tackles Nurse Staffing
and Workforce Challenges
The nursing shortage and workforce forecasts
vary depending on the source, but one thing is for
certain: it weighs heavily on levels of nursing and
practice settings, from frontline nurses and chief
nursing officers to academia. The bottom line is that
it jeopardizes the care we provide to our patients and
clients, and the quality of life for our communities.
Addressing the multiple issues attributing to the
shortage and ongoing staffing concerns will require
several strategies employed in tandem. The American
Nurses Association (ANA) in conjunction with the
American Organization of Nurse Leaders (AONL) and
the Healthcare Financial Management Association
(HFMA) recently released a white paper addressing
the optimal allocations of nursing resources.
Building on these efforts, VNA convened the
Nurse Staffing & Workforce Group in early 2018. The
group is composed of nurse leaders representing an
array of organizations and practice settings, and has
the goal of identifying a shared path to positively
impact the nursing and healthcare workforce
shortages in Virginia.
The group has identified six primary focus areas
shared below in no particular order of priority:
• Project workforce needs based on population
This includes forecasting by population needs
and ability to care for those within these
specialty areas; and the alignment of core
competency needs and education’s ability to
keep pace with these growing needs.
• Support innovative clinical care delivery
models in which team members practice to the
full extent of their preparation
The group further discussed utilizing
technology solutions to provide predictive
analytics for staffing numbers, while also
aligning skill set, education, and competency
with patient/client assignments to enhance
quality care provision.
• Construct a model of nursing progression
at the point of care to enhance nursing
satisfaction, retention, and elevate patient care.
• Develop a coordinated academic practice model
of student clinical experiences and create a
pipeline for progression to meet workforce
This includes preparation for specific fields
of practice; pipeline enhancement for nursing
assistants, ease of access to education, and
funds to support entry level educational
pathways and stackable credits.
• Enhance alignment between education,
practice, finance, and regulation to assure
• Ensure that diversity exists in the workforce
and mimics the populations being served.
The group was expanded to include representation
from the Virginia Association of Colleges of Nursing
(VACN) and the Virginia Organization of Nurse
Executive Leaders (VONEL) at our most recent
meeting last month. These organizations are also
working to address nurse
staffing and workforce
issues. The targeted
outcomes of VACN and
VONEL are to:
MBA, BSN, RN
• Identify the roles in nursing that will assist
in addressing the health priorities across the
• Detect gaps in the nursing workforce relative
to knowledge, skills, and transition to practice
now and in the future
• Distinguish what infrastructure and resources
are necessary for collaboration across the
The priorities identified by VACN and VONEL
align on multiple levels with those of VNA’s Nurse
Staffing & Workforce Group. As we move forward,
both groups plan to engage in ongoing collaboration
to further advance and enhance the work around
nurse staffing and the nursing workforce. Our next
meeting will occur in early February.
This is an extremely important step as the
inability of nursing to provide a unified front creates
further challenges and distractions. The goal of
VNA’s Nurse Staffing & Workforce Group, VONEL,
and VACN is to provide a unified voice on nurse
staffing and workforce initiatives. In this way, we
can collectively and uniformly educate the public
and collaborate with other partners to help advance
our work on behalf of nurses throughout the
commonwealth. Stay tuned for more!
Page 6 | February, March, April 2020
Virginia Nurses Today | www.VirginiaNurses.com
Welcome to the Year of the Nurse!
This year, VNA, ANA, and organizations
worldwide are expanding the traditional nurses’
week to a full month, and further recognizing 2020,
as the Year of the Nurse!
Nurses account for nearly 50% of the global
health workforce and play a vital role in providing
health services worldwide. As nurses, your care
for the individual begins before they’re born and
continues until they take their final breath and, like
never before, you’ve needed to rise to the challenge
of increasing acuities and a rapidly changing
healthcare delivery system. You’re the first and
often only healthcare professional your patients and
clients see, and as such, you are in a unique position
to join us as we work to educate the public about
who today’s nurse is. This increased understanding
of the complexity, breadth, and depth of the nursing
role is essential, as ANA President Dr. Ernie Grant
recently said, “in order to expand investment in
education, practice and research.”
Throughout the year we’ll be working with our
organizational partners to advance initiatives
related to essential community health services,
identify real solutions to a myriad of staffing issues,
and advance nursing and access to healthcare
services in the legislative and regulatory arena.
In great part, our successes will hinge on having
you by our side and engaged in the process. Be
sure to stay informed with our weekly VNA News
Brief, legislative action alerts, and calls-to-action
throughout the year, and respond to our issuesfocused
surveys. We want to know what you think!
And if you’re not already a member, please add your
voice to those of our more than 4,000 members, by
joining today…. At just $15/month, now is a great
time to join! https://tinyurl.com/JOIN-TODAY
And of course you have great cause for
celebration. Not only has nursing been recognized
for the 18th consecutive year as the most trusted
profession in the US, it’s also the 200th anniversary
of Florence Nightingale’s birthdate! Be sure to post
your photos remembering Florence, celebrating the
Year of the Nurse… and celebrating YOU on our
Facebook page (www.facebook.com/vanurses) for
all to enjoy. Alternatively, you can send your photos
to our communications coordinator, Elle Buck, at
We’ll be celebrating
several individual nurses
in future 2020 issues of
Virginia Nurses Today;
nurses leading at all levels Janet Wall
and in various practice
settings, so stay tuned! For now, I thought you
would enjoy reading some inspiring stories of nurses
leading the way from around the world!
• Eva Tegnander – educating midwives in
Norway on ultrasound for more than 30
• Inés Maria Comino Sanz: A nurse researcher
in Spain helps bring evidence into practice.
• Community nurses in Romania – the eyes,
ears and voice of people in need. https://
• Natalya Saulskaya: as a nurse [in Russia],
I worry for every baby who hasn’t been
We have much to do as we work to raise the
visibility of the nursing profession in policy dialogue
and develop and grow the nursing workforce. Let’s
make it a great year… together!
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100 Most Influential People in Healthcare
includes Past VNA President
ANA Enterprise Chief
Executive Officer and
Past VNA President
Loressa Cole, DNP,
MBA, RN, FACHE, NEA-
BC, was named one of
Modern Healthcare’s “100
Most Influential People in
Healthcare.” This awards
and recognition program
honors individuals in
healthcare who are
deemed by their peers
and an expert panel to be the most influential
individuals in the industry based on leadership
and impact. For more information on the 100
Most Influential People in Healthcare - 2019, visit
Dr. Cole has more than 30 years of nursing and
leadership experience. She served as president of the
Virginia Nurses Association from 2012 until 2014.
Dr. Cole became the ANCC Executive Director and
Executive Vice President in 2016 and in 2018 was
appointed as the ANA Enterprise CEO. You can learn
more about Dr. Cole and her accomplishments at
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www.VirginiaNurses.com | Virginia Nurses Today February, March, April 2020 | Page 7
UVA Nursing Students Tackle Climate
Change Induced Disaster in Class
A hurricane devastates a rural town where
mounting injuries from a building collapse, chemical
burns, and multiple car accidents, create a frenzy
of need. Uninjured victims frantically search for
missing loved ones, disrupting and distracting
already overwhelmed emergency responders while
medical supplies—bandages, defibrillators, clean
water, and splints—are in drastically short supply.
Then the power goes out. What do you do?
Thankfully, it’s just another day in the Clinical
Simulation Learning Center, UVA School of
Nursing’s 10,000-square-foot lab. Nursing students
in two countries are testing their mettle in practice
scenarios involving disasters caused by extreme
weather to gain a better sense of what makes
communities both prepared and resilient in the face
of climate change.
Through the school’s partnership with peers in
Bluefields, Nicaragua, a low-lying coastal community
hit hard by the realities of climate change, UVA’s
Global Initiatives director and Nursing Professor
Emma Mitchell has expanded the richness of
simulated scenarios. UVA nursing students and
their counterparts from the Bluefields Indian
and Caribbean University (BICU) practice and
refine drills both separately and together, offering
immediate feedback on the experience and their
Over the last several years Mitchell has taken
more than 50 nursing students to Bluefields
in small groups. In addition, BICU faculty and
Bluefields’ public health officials visit UVA to offer
students a sense of climate change’s impact on their
communities and a portrait of how they’re preparing.
“If we look at nursing study abroad programs
across the U.S., they’re all guided by good
intentions,” says Mitchell, a public health nurse and
global health scholar. “But not all of these are guided
by a vision that really emphasizes sustained cultural
and professional engagement. For too long we’ve had
a history on a national scale of offering students
experiences where they parachute into a community
to provide services that may not be in line with
community needs, or socio-culturally appropriate,
and then leave.”
“Our partnership with Bluefields, a true ideas
exchange,” she adds, “is intended to lead a new trend
in global engagement.”
Much of what’s rich about the exchange is
embedded in the lived experience of Mitchell’s
Bluefields partners. Faculty including BICU
professor and nursing school director Diana
Hodgson and Youth Program Coordinator for
the Región Autonoma Costa Caribe Sur Gorman
Jaenstchke lived through hurricanes Mitch (1998)
and Joan (1988). These events impacted the lives
of thousands of Nicaraguans, devastated crops and
infrastructure, and displaced millions of central
“Before [Hurricane] Joan,” Jaenstchke said to
students on a recent visit to UVA, “I wasn’t prepared.
My Bluefields region wasn’t prepared. And that’s
why the institutions, the families, the regions, the
leaders—all of us are working together to make a
plan. Bluefields is getting prepared, that’s why we
have these exchanges.”
In addition to disaster simulation, UVA students
also learn how climate change is affecting Bluefields
more globally from its economy to its fishing,
agriculture, and young people’s labor market
engagement, gleaning a more nuanced view of how
changing weather patterns can impact every facet of
The biggest lesson though is the need to plan for
climate change, a process that nurses can help lead,
We Want to Know!
How’s the health of your workplace?
The health and culture of every practice
setting plays an important role in the
happiness, retention, and well-being of its
staff. VNA’s Healthy Workplace Culture
Workgroup is conducting a brief survey to
assess the health of all types of workplaces
throughout Virginia. We’re eager to learn
which areas are most challenging and to also
glean your ideas for creating healthier work
OPTIONAL: Complete the survey by
Wednesday, March 18 for a chance to win
one of two VNA “Keep Calm & Nightingale On”
canvas tote bags! All survey responses will be
kept strictly confidential.
Visit https://tinyurl.com/vghdlos to
complete the survey. Thank you for your
Ask about scholarships or
employer tuition reimbursement
Free to Nurses
can point you right to that
perfect NURSING JOB!
Easy to Use
E-mailed Job Leads
Page 8 | February, March, April 2020
Virginia Nurses Today | www.VirginiaNurses.com
| Glen Allen, VA
The Virginia Nurses Association’s 2020
Spring Conference, Cultivating a Happy Work
Environment, will take place on Wednesday,
April 22. Join us as we investigate what happy
work environments look like and discuss how
participants can build a culture of happiness
within their organizations.
VNA members have shared that in order to
improve nurse engagement and retention, they
need the knowledge and resources to address
workforce issues, including improving the
environment they work in. Speakers will examine
crucial issues such as navigating change,
staying engaged personally and professionally,
communicating effectively with co-workers, and
strategies to strengthen professional teams. This
program is for nurses across all practice settings
who want to improve their work environment to
ultimately maximize their team’s outcomes.
Julian Lute, a
consultant from Great
Place to Work®, will
that companies on
Fortune’s “100 Best
Companies to Work
For” list use to build a
beat the market to
attract and retain
talent, and will reveal
how you can apply
these tactics within
your organization. Lute has more than 15
years of experience as an operational leader
and consultant. He works with top leaders
from Fortune 100 companies to connect the
dots between superior business performance
and a best-in-class employee experience.
Lute has a history of working with some of
the largest businesses in manufacturing,
information, technology and retail including:
AT&T, McDonald’s, Dow Chemical, 3M, Workday,
Princess Cruises, Weight Watchers, Activision
Blizzard, and Virgin America/Alaska Airlines.
Cultivating a Happy Work Environment will be held
at the Place at Innsbrook in Glen Allen, VA (20
minutes west of downtown Richmond) in addition
to satellite locations in southwest and northern
More details including topics, speakers, and
contact hours are available online. Registration
is open at https://virginianurses.com/page/
2020SpringConference. The price is $139 for
members and $169 for nonmembers. Questions?
Contact Jackie Jester at jjester@virginianurses.
Share Your Best Practices or Pitch an Idea!
If you and your team have an innovative
best practice that has cultivated a happy work
environment in your setting OR you have an idea
for how to transform your work environment, we
want to hear from you!
We are accepting abstracts for Short Podium
Presentations and Pitch an Idea Sessions.
Participants will leave with the knowledge and
resources to cultivate a happy work environment
that will improve outcomes. Our planning
committee is looking for best practices and ideas
from across different nursing environments
and specialties, so no matter where you work
– on the frontline, in a leadership role, serving
in academia, advanced practice, in acute care,
the community, or long-term care – we want to
learn from you! The Short Podium Presentations
and Pitch an Idea Sessions will be 20 minutes in
Dates for Submission
Submissions are being accepted now. The
deadline to submit abstracts for both podium and
idea pitches is March 6, 2020. You may submit
your abstract electronically here: https://form.
If you have difficulty accessing the form at your
workplace, please try your mobile device or home
The abstract review committee will review all
submissions and notify selected presenters by
March 25, 2020.
Submissions will be evaluated based on:
• Presentation: grammar, spelling, clarity
• Content: substantive, current, of interest to
• Relevance: provides knowledge on best
practices or new approaches to cultivate a
happy work environment OR provides an
innovative idea for how to cultivate a happy
• Outcomes: demonstrates potential or actual
outcomes, describes what tools or standards
were used or would be used to measure
outcomes, and discusses transferability
to other practice environments and
Who May Submit
Anyone who has a best practice OR an idea
related to cultivating a happy work environment,
may submit an abstract to be considered to serve
as a podium presenter.
Short Podium Presenter Requirements
• Selected presenters will be provided a
template to follow for presenting at the
conference. Presenters should be prepared to
speak for 20 minutes, including five minutes
for questions. All final presentations will be
due by April 1, 2020.
• Podium presenters will be required
to submit all necessary forms by the
deadlines provided in the acceptance letter.
Acceptance as a presenter will be contingent
upon a conflict of interest assessment. VNA
reserves the right to rescind the acceptance
of an abstract due to any conflict of interest
discovered after acceptance.
• Presenters are responsible for all
costs associated with registering for
the conference and all travel and
accommodations. Conference agenda and
registration is at www.virginianurses.com
Idea Pitch Presenter Requirements
• Selected presenters will be provided a
template to follow for presenting their idea.
Presenters should be prepared to pitch their
idea in 10 minutes and facilitate discussion
and field questions for 10 minutes. All
presentation slides will be due by April 1,
• Idea pitch presenters will be required
to submit all necessary forms by the
deadlines provided in the acceptance letter.
Acceptance as a presenter will be contingent
upon a conflict of interest assessment. VNA
reserves the right to rescind the acceptance
of an abstract due to any conflict of interest
discovered after acceptance.
• Presenters are responsible for all
costs associated with registering for
the conference and all travel and
accommodations. Conference agenda and
registration is at www.virginianurses.com
Applicants must submit their abstract
electronically here: https://form.jotform.com/
The submission must describe a best practice
or idea for a new practice that focuses on
cultivating a happy work environment. Please
provide the title and a two to four sentence
description of the presentation. The abstract
should be a maximum of 250 words and should
• Description of the best practice or idea to
cultivate a happy work environment
• Implementation strategies
• Potential or actual outcomes and what tools
or standards were used or would be used to
• Implications for practice and transferability
Please do not reference the organization/
author(s) within the title, program description, or
Please feel free to share this call for presenters
with any individual or organization that has a best
practice or idea to share related to cultivating a
happy work environment!
You can find out more about how to submit
an abstract by visiting the spring conference
webpage at https://virginianurses.com/page/2020
www.VirginiaNurses.com | Virginia Nurses Today February, March, April 2020 | Page 9
Page 10 | February, March, April 2020
Virginia Nurses Today | www.VirginiaNurses.com
Expanding Access to Primary Care in Free and Charitable Clinics:
Cynthia Fagan, Rebecca Bates, Susan Adamson,
Paula Hill-Collins, & Teresa Tyson
A major challenge facing the U.S. healthcare
system is the current and future projected workforce
shortage of primary care physicians (PCP).
Population growth and a growing elderly population
accompanied by an increasing prevalence of chronic
diseases associated with aging places the greatest
demand on primary care services. Expanded health
insurance coverage under the Affordable Care
Act (ACA) and Medicaid expansion is expected to
further widen the supply and demand gap. A deficit
of 23,640 PCPs is projected by the Health Resources
and Services Administration (HRSA) National Center
for Workforce Analysis by 2025. 1 This finding is
consistent with recent projections developed by the
Association of American Medical Colleges (AAMC),
which suggest that PCP shortfalls may range from
14,900 to 35,600 by 2025. 2
In addition to the PCP workforce shortage, there
is a maldistribution of physicians in rural and
medically underserved areas. In Virginia, there
are 105 designated health professional shortage
areas (HPSA) for primary health care affecting
a population of 1,559,609. 3 Virginia is also
challenged with a significant uninsured rate of
10.3% between 2016 and 2017 for nonelderly (ages
0-64), representing about 719,000 individuals,
87.6% of whom were adults. 4 This estimate does not
account for Virginia’s Medicaid expansion, available
to residents earning up to 138% of the poverty
level. As of October 2019, approximately 325,000
Virginians had gained coverage. 5 Despite Medicaid
expansion, there remains a significant number of
uninsured adults who are much more likely than
those insured to have unmet health needs and are
less likely to receive preventive services. 4
Virginia’s free and charitable clinics serve as
an important safety net resource in meeting the
unmet health care needs of the uninsured, Medicaid
and other vulnerable patients. Safety net clinics
provide a variety of services including, chronic care,
specialty care, dental care, pharmaceutical care,
vision care, women’s health, mental health, health
education, case management, care coordination,
and various supportive services. Harnessing the new
autonomous licensure law for nurse practitioners
(NPs) will expand access by allowing NPs with five
or more years of clinical experience to practice
without the restriction of a mandated collaborating
physician and can help mitigate the shortage of PCPs
by increasing provider capacity in safety net clinics.
This article will discuss how NPs are leveraging the
autonomous licensure law to increase access to care
in three of Virginia’s free and charitable clinics – the
Health Wagon, the Harrisonburg-Rockingham Free
OF JUVENILE JUSTICE
The Virginia Department of Juvenile Justice
(DJJ) currently has openings for both
Registered Nurses and Licensed Practical
Nurses at Bon Air Juvenile Correctional Center
in Chesterfield Virginia. DJJ provides primary
medical, dental, and psychiatric care to youth
committed to state custody. Nurses are an
integral part of the multidisciplinary teamwork
at Bon Air JCC. Nurses at the facility administer
medication, respond to patient medical
requests, provide chronic care treatment, and a
range of other nursing treatments.
We offer a generous state benefits package
which includes a defined benefits pension
plan, health insurance, annual leave, education
leave, and 12 paid holidays. For a complete job
description and to apply online please visit us at:
www.djj.virginia.gov and click on ‘DJJ Careers’.
Clinic and the Adams Compassionate Healthcare
Autonomous Licensure Law
The autonomous practice licensure law for
Virginia NPs became effective January 7, 2019,
following promulgation of regulations by the Joint
Boards of Nursing and Medicine. The new law,
codified under Virginia Code § 54.1-2957, reforms
scope-of-practice (SOP) permitting qualified NPs to
be licensed to practice independently. 6 Elimination of
the career-long collaborative agreement with a team
physician following a transition to practice period
is a significant public policy change projected to
increase the primary care workforce across the state.
Eligible NPs must meet a five-year full-time
clinical practice experience equivalent and file
an attestation from their collaborating physician
with the Board of Nursing (BON). Clinical practice
experience is delineated as the postgraduate
delivery of healthcare directly to patients, which
unfortunately excludes administrative and faculty
teaching time. The five-year full-time equivalent
is based on a 36-hour work week and is defined
as 1,800 hours per year for a total of 9,000 hours. 7
Applications for autonomous practice licensure
are available on the BON at https://tinyurl.com/
y5val9y8. The application requires a signature by
the patient-care team physician(s) affirming that:
1) The physician served as the NP collaborator
pursuant to a practice agreement;
2) The physician routinely practiced with a
patient population and in a practice area for
which the NP is certified and licensed; and
3) The time period practiced with the NP
pursuant to the practice agreement.
If circumstances inhibit the NP from obtaining an
attestation from the collaborating physician, “other
evidence” meeting the qualifications for autonomous
practice licensure may be submitted. 7 A one-time
administrative fee of $100 per certification category
in which the NP is licensed and certified is required.
Upon verification that requirements have been met,
a new “autonomous practice license” is issued and
the NP may practice autonomously.
Since implementation of the new autonomous
practice licensure law, 639 NPs have obtained
autonomous licensure. This represents
approximately 16% of an estimated 4,000 eligible
NPs. These numbers are expected to grow with
uptake of the new law and development and
diffusion of innovative service delivery models.
Autonomous NP practice in Virginia has the
potential to decrease healthcare costs, improve
access to care, particularly in rural areas, and
improve evaluation of healthcare metrics for NPs.
Robust evidence supports the high-quality of
care that NPs provide 7-38 and increasing numbers
of policy influencing bodies have recommended
expanding the use of NPs in primary care. 39,40 In
states where full SOP for NPs is in place, access
to care increases in rural and underserved areas.
In states with restricted SOP for NPs, statistically
significant higher rates of poverty, uninsured, and
unemployment are observed. 41-43 Removing SOP
barriers such as collaborating agreements has
demonstrated increased access to care for the most
vulnerable populations in these states.
The quality of care NPs provide to Medicare
beneficiaries has been well documented with
a recent study demonstrating lower hospital
admission and readmission rates, emergency
department (ED) use, and imaging for low back
pain as compared to physicians. 44 In states that
expanded Medicaid, ED visits increased by 28% in
states with restricted SOP for NPs whereas in states
with autonomous practice laws for NPs, ED visits
increased by only 7%. 45 The decreased utilization
of EDs for non-emergent conditions provides a
significant cost-savings to the healthcare system.
In states with fewer SOP restrictions, NPs were
more likely to independently bill Medicare for
services provided in rural areas thereby increasing
access to care for rural dwelling elders and
individuals with disabilities who are dual eligible
for Medicaid and Medicare. 46 In fact, reimbursement
costs for care provided by NPs for evaluation and
management services was 29% less than that for
physician managed care. 47 This demonstrates an
opportunity for cost-savings among this population
without sacrificing quality or outcomes.
From a workforce perspective, NPs practicing in
rural and underserved areas were more satisfied
with their jobs, worked to the top of their license,
education and training, and were less likely to
look for a new job. 48 Examination of workforce
development for NPs reveals academic-community
partnerships offer an opportunity to expose more
students to clinical practice sites working with
underserved populations while providing additional
support or resources to these preceptors who are
often the only provider in a large geographical
Malpractice is a common concern among
healthcare providers. In states with full SOP laws
for NPs, one extra regulatory effect of autonomous
practice has been a decrease in physician
malpractice payments by up to 31%. 51 Removing
SOP barriers may reveal the actual malpractice
claims paid by provider type, which will improve
transparency in malpractice evaluation between
Impact of Autonomous NPs in Free and
Susan Adamson, MS, FNP-BC has served as
a volunteer NP clinical provider for over 22 years
at the Harrisonburg-Rockingham Free Clinic,
which provides medical care to low-income,
uninsured adult residents. Ms. Adamson also has
the distinction of being the first NP in Virginia to
be issued an autonomous practice license. She
reports full support from the two physician medical
directors for autonomous practice demonstrated by
signatures on NP attestations and support of clinic
policy changes in support of full use of NPs. The
clinic’s governance board has embraced the new
law with support for changes to clinical policies by
the professional services subcommittee to utilize
autonomous licensed NPs to the fullest. Changes in
the credentialing of clinicians have been updated.
“Essentially, NPs with autonomous practice
licenses, once verified and with no sanctions,
can begin to see patients.” They are of course
added to the clinic’s Division of Risk Management
clinician list. NPs without autonomous licensure
are still assigned to a practice agreement with
one of the medical directors. Several “NP slots”
have been opened up by autonomous licensed
NPs. Additionally, autonomous licensure has
increased the ability to spend more time and
resources focusing on healthcare delivery instead
of the administrative burdens associated with
collaborative practice agreements, chart reviews,
www.VirginiaNurses.com | Virginia Nurses Today February, March, April 2020 | Page 11
Leveraging the New Nurse Practitioner Autonomous Practice Licensure Law
etc. Ms. Adamson states, “It has been such an easy practice change for us in
Rebecca Bates, DNP, APRN, FNP-C practices with the Adams Compassionate
Healthcare Network with only four administrative and clinical employees and
herself as the only paid clinician. The clinic provides medical services to lowincome
and uninsured individuals for free or at a low cost. The clinic has
volunteer providers including physicians and a medical director who owns his
own practice. Under a collaborative agreement, Dr. Bates had to ensure the
collaborating physician was available for consultation as needed. If he left the
country to visit his family overseas or was otherwise unavailable, she would
not be able to practice. With autonomous practice licensure, Dr. Bates is not
required to practice with a collaborating physician. Additionally, any NPs who
have obtained their autonomous practice licensure and wish to volunteer in the
clinic do not need to have a collaborative agreement with the medical director.
This reduces the required oversight and nullifies the limit on the number of NPs
a collaborating physician may have an agreement with at any one time.
Dr. Bates states, “Autonomous practice has allowed me to seamlessly
integrate my scope of practice into the workflow and the care I provide in the
clinic.” As a preceptor, her NP students learn to participate in clinical care and
consultation as any healthcare provider does. Mandating a single provider for
collaboration is an onerous and ineffective model that reduces access to care,
particularly in a vulnerable population such as the uninsured. “My students
now learn to consider which healthcare provider is the most appropriate for a
particular consultation; it is most often not another primary care provider.”
Teresa Tyson, DNP, FNP-BC, FAANP is the executive director of the Health
Wagon and Paula Hill-Collins, DNP, FNP-BC, FAANP is the clinical director.
The Health Wagon’s mission is to provide compassionate, quality health care
to the medically underserved people in the mountains of Appalachia. 98% of
the Health Wagon’s patients are uninsured. Drs. Tyson and Hill report that the
autonomous practice licensure law has removed a tremendous burden of “fear
of losing our collaborative physician” who is in his seventies though remains
active in practice. The new law has allowed them to add two additional NPs to
the clinic. Dr. Collins-Hill states, “The law also permits NPs to freely volunteer
without the requirement for a collaborative physician at the M7 Move Mountains
Medical Mission (formerly Wise RAM).” This event, held annually at the Wise
Fairgrounds, serves thousands of individuals who come to get needed free eye,
dental, medical and diagnostic services. The new law has increased access to
services provided by the Health Wagon.
contextual factors that may enhance or impede uptake. Finally, an organization
may implement and monitor the policy and practice changes associated with
autonomously licensed NPs. NPs are qualified to independently deliver highquality
care and already do so in 22 states plus the District of Columbia. 53
Embedding policies and practices that fully utilize autonomous NPs in the
organization increases primary care capacity and access to care.
The autonomous practice licensure law for Virginia NPs effective since
January 7, 2019, has the potential to mitigate the primary care workforce
shortage and increase access to care across the state. With delivery system
changes and full utilization of NP and physician assistant (PA) services,
the projected shortage of 23,640 PCPs by 2025 can be effectively mitigated. 1
Although NPs and PAs do not replace physicians, studies have shown that NPs
and PA practitioners can augment and expand physician capacity in many
care settings. 54, 55 NPs can manage 80 to 90% of care provided by primary care
physicians such as: take medical histories, conduct exams, order and interpret
tests, develop treatment plans, and provide preventive care. 56 Leveraging use of
autonomous licensed NPs in free and charitable clinics is a strategy to increase
primary care capacity to address the health care needs of Virginia’s uninsured,
Medicaid recipients and other vulnerable patients.
For a full list of references, please visit https://cdn.ymaws.com/
Debunking Barriers and Misinterpretations
Some physicians and professional medical associations have justified their
support for limiting NP SOP regulations on the grounds that they are necessary
for the health and safety of patients from non-physician providers. 52 The robust
evidence-based research presented in this article argues against this stance.
In its 2010 evidenced-based report, The Future of Nursing: Leading Change,
Advancing Health, the Institute of Medicine (IOM) called on states to eliminate
“outdated regulations and organizational and cultural barriers that limit the
ability of nurses… to practice to the full extent of their education, training,
and competence.” 39 Virginia state legislators have removed restrictions on NP
SOP with passage of the autonomous licensure law. It is now incumbent for
organizational policy makers such as credentialing and governing boards
to revise policies permitting NP practice to the fullest extent of education and
training. Failure to fully integrate use of autonomous NPs into healthcare
delivery models will be at the expense of accessible care for many vulnerable
Institutionalizing Autonomous Licensed NPs
A first step in the process to institutionalize autonomous licensed NPs is
garnering professional and political support from diverse stakeholders in the
organization. Starting discussions with stakeholders, including the board of
directors, administrators, nurse practitioners, physicians and other healthcare
workers surrounding the new licensure law is necessary for buy-in and to
address any knowledge gaps or misperceptions. These discussions must include
participatory approaches with bi-directional communication. The systematic
presentation of the evidence-base on NP safety, quality and cost-effectiveness
can be a powerful tool to build support for policy change and to dispel
misconceptions. Implementation also commonly requires behavior change
among individuals or organizations, and therefore a deeper understanding of
the social, economic, institutional or cultural attitudes must be considered as
Join our team today!
We are currently hiring for the following positions:
Licensed Practical Nurses
Please apply at our website at www.diamondhealthjobs.com
Looking for nurses with a passion for the behavioral health field.
Page 12 | February, March, April 2020
Virginia Nurses Today | www.VirginiaNurses.com
Social Determinants of Health:
The Zip Code is the Most Important Number on the Patient’s Chart!
• Nurses can earn 1 nursing contact hour for
reading Social Determinants of Health: The
Zip Code is the Most Important Number on
the Patient’s Chart. Participants must also
complete the continuing education post-test
found at: https://virginianurses.com/page/
• This continuing education activity is FREE
for members and $15 for nonmembers!
• The Virginia Nurses Association is
accredited as a provider of nursing
continuing professional development by the
American Nurses Credentialing Center’s
Commission on Accreditation.
• No individual in a position to control
content for this activity has any relevant
financial relationships to declare.
• Contact hours will be awarded for this
activity until February 15, 2023.
• Disclaimer: The opinions expressed here
are solely the author’s and do not represent
those of the United States Government, the
Department of Defense, or the United States
Elaine Bruner, MSN, RN-BC
Elaine received her BSN
from the State University
of New York at Plattsburgh
and MSN from the University
of Virginia. Her nursing
practice has included
oncology, nutrition support/
home infusion, home health/
and physical rehabilitation.
Elaine has more than 15
years of case management
experience and received Nursing Case Management
certification/ANCC, in 2002. She is a member of the
Hampton Roads and Alamo Case Management Society
of America (CMSA) chapters. Elaine also serves as
Immediate Past President of the Hampton Roads
Case Management Society (HRCMS) and as the 2015
HRCMS chapter conference Chair. Currently, she is
faculty for the Nurse Case Management reviews with
the ANA/American Nurses Credentialing Center and
co-authored Nursing Case Management Review and
Resource Manual (4th ed.) with Margaret Leonard.
Her publications include manuscripts in Home Health
Care Nurse, Home Health Care Advisor, Case In Point,
CMSA Today and The Case Manager. Elaine has been
faculty for national, state and regional meetings on
home health care and case management topics. She
serves on the Virginia Nurses Association Commission
on Nursing Education and the CMSA Nominating
Committee. In 2008, she was selected for the Award of
Service Excellence from the CMSA. Elaine is honored
to be the nurse case manager with Navy Special
Warfare, Virginia Beach.
Challenged by high need, high cost patients
who struggle with adherence and self-care? Too
often the lack of healthcare funding may not be
the primary challenge for people as they live with
chronic illnesses, struggle to secure preventive care
or survive a catastrophic injury. Historically, our
healthcare and social service delivery systems are
not well-equipped to effectively manage patients with
multiple chronic diseases and complex social needs
such as food, housing, or substance abuse services.
In the November 1919 issue of the American
Journal of Nursing, Isabel M. Stewart shares “The
roots of disease are usually found in bad housing,
inadequate food, overwork and hundred other
causes…If a nurse is to help in the prevention of
disease, she has to get back to the unsanitary
conditions which produce disease.” And here we
are, 100 years later, asking how we can advocate,
educate, and facilitate the best healthcare for people
facing barriers that may not be captured in an
admission assessment or medical history/physical.
Consider the elements of a biopsychosocial
assessment and the valuable information available
by knowing where your patient lives, works, shops for
food or even exercises. These elements will positively,
or negatively, influence the transition of care/discharge
plan. Often the social determinants of health (SDOH),
impact a person’s ability for self-care more than
the diagnosis or available insurance. It is widely
recognized that the health of populations is often
determined by social factors other than health care.
SDOH can be the identified barriers for a seamless,
safe transition to self-care. Being knowledgeable on
the SDOH, identifying the actual, or potential barriers,
then deploying appropriate resources will enable
nurses to be a successful advocate for a patient’s
continued healthcare and services.
How are the SDOH defined? In 2008, the World
Health Organization defined social determinants of
health (SDOH) as the conditions in which people are
born, grow, live, work, and age. These circumstances
are shaped by the distribution of money, power,
and resources at global, national and local levels.
Consider the person with newly diagnosed diabetes
and their lifestyle modifications including diet and
exercise. How do they adhere to appropriate food
choices if they live in a food desert neighborhood
that lacks a full service grocery store? What about
exercise where there are no sidewalks or parks?
And to adhere to their primary care appointments
requires a two hour public bus ride, one-way.
These circumstances seem daunting to a healthy
person; imagine what it presents to someone with
limited functional abilities or financial resources.
Managing social determinants within population
health is critical to improving outcomes, closing
care gaps, and lowering the cost curve. Nurses
are well-positioned to identify the SDOH, increase
patient engagement by integrating SDOH to improve
adherence, offer better access, and promote health
The five domains that describe the SDOH are:
• Economic Stability such as available
employment; housing; and food security
• Education such as early childhood education;
high school completion; and job training.
• Neighborhood and Built Environment
such as environmental conditions; crime and
violence; and quality of housing.
• Health and Healthcare such as available,
accessible providers; and health literacy.
• Social and Community Context such as
discrimination; racism; and incarceration.
Healthy People 2020, www.healthypeople.gov
Assessment of SDOH
Assessing the SDOH means asking personal,
probing, and often delicate questions regarding a
person’s lifestyle, home environment, or finances.
Consider elements outside of traditional healthcare
questions when assessing barriers to self-care.
Early assessment, screening, and interventions are
imperative. Prepare by reviewing all available data
prior to meeting a patient/family/caregiver. There
may be statements that offer clues to non-adherence
such as “non-compliance with meds” or “no-show for
second scheduled appointment.” Nurses are poised
to assess elements that are not included in the
usual history and physical, yet present tremendous
barriers to patient adherence, self-care, and
healthy living. What questions will yield additional
information related to SDOH? Consider the
psychosocial issues that are currently reviewed such
as housing, income, support system. What about
food security, neighborhood crime, or incarcerated
family members? Each has an effect on a person’s
ability to self-manage a chronic health problem or
According to the United States Department of
Agriculture, one of eight people in the USA faces
food insecurity (USDA, 2019). To address food
insecurity, use the Hunger Vital Sign, developed by
Drs. Erin Hager and Anna Quigg in 2010; it offers
insight into a family’s ability to secure adequate
food. The Hunger Vital Sign identifies individuals
and families as being at risk for food insecurity if
they answer that either or both of the following two
statements is ‘often true’ or ‘sometimes true’ (vs.
“Within the past 12 months we worried
whether our food would run out before we got
money to buy more.”
“Within the past 12 months the food we
bought just didn’t last and we didn’t have money
to get more.”
How about addressing crime and violence in a
person’s neighborhood? Are you comfortable asking,
“Do you feel safe walking in your neighborhood?”
What about the housing or built environment? Many
older housing developments may have lead paint or
asbestos in the building. Nurses can, and should,
ask the hard questions which yields information to
support interventions that improve healthy living.
Transportation is a barrier for people in many
locations. The issue is more than whether or not
the public bus stop is within walking distance.
Travel time, the number of transfers, or safe
locations are all considerations. In rural areas
without public transportation the challenges may
be access to private vehicles with licensed drivers,
fuel costs, and distance to healthcare providers.
The simple question, “How do you get to your doctor
appointments?” offers nurses clues to an individual’s
transportation access and its impact on other SDOH
such as grocery shopping or neighborhood safety.
The United States locks up more people per
capita than any other nation. Incarceration extends
to the children, families and communities who
must manage the social, financial and emotional
effects. Decreased income, lack of family support or
caregivers, plus the stigma of jail time have life-long
consequences. When a parent faces prison, their
children may go into foster care. Adverse Childhood
Experiences (ACEs) may include all types of abuse,
parental mental illness and incarceration. ACEs
impact future health and lifelong opportunity; learn
more at https://www.cdc.gov/violenceprevention/
childabuseandneglect/acestudy. When a parent
is imprisoned, the family finances may become
strained and the risk of homelessness increases.
Prison time may ban people with certain convictions
from receiving government benefits or subsidized
housing. Higher rates of incarceration tend to
occur in communities where poverty, violence and
increased police presence are seen. Jail takes a
tremendous toll on families and neighborhoods.
Learn more at http://humantollofjail.vera.org/thefamily-jail-cycle/.
A community health needs (CHN) assessment
offers critical data on a locality’s healthcare
service needs and issues through comprehensive,
systematic data collection and analysis. These
assessments, required every three years, identify
unmet community health needs and justify how and
where resources should be allocated to best meet a
location’s needs. Investigate your community’s CHN
for additional information, https://www.cdc.gov/
How do nurses intervene when they identify
www.VirginiaNurses.com | Virginia Nurses Today February, March, April 2020 | Page 13
SDOH needs that affect adherence, access
and overall health? Connecting individuals to
appropriate resources, public and private, will
follow from the nurse’s assessment and identifying
SDOH needs will improve health and address
health disparities. Early referral to a social worker
or case manager offers immediate intervention for a
myriad of public, private and charity resources. Any
offered resource that has restrictive requirements,
or is inconvenient, will be less valuable to an
individual and their family/caregiver. Examine the
available resources in your organization such as
a central community referral center where the gap
between clinical care and community services can
be addressed. Embedded public benefits workers
who assess eligibility and offer enrollment on-site
streamline the application process thus lessening
the burden, and stigma, of enrollment.
What about sending discharged patients home
with food? Medications from a medical pharmacy;
food from a food pharmacy? Sentara CarePlex
Hospital in Hampton, VA offers a Food Pharmacy,
in partnership with the Virginia Peninsula Food
Bank, that provides comprehensive care to heart
failure patients. How about discharging identified
patients with three days of groceries? Or offering
one week of home delivered meals? Collaboration
between hospitals, clinics, community resources
and health plans are successfully addressing
food, transportation and loneliness/isolation. One,
or all, of these challenges may result in hospital
readmission or impact a person’s self-care ability.
Collaborating across service lines to create a
meaningful resource directory that is transparent
to all users is essential to addressing SDOH.
Transitions of care occur 24/7, 365 days a year
so all healthcare professionals appreciate a
comprehensive resource. Colleagues in all settings
have their “go to” people, providers and agencies.
Merge those contacts into a “resource bank” that is
critical outside of regular operating hours or when
a social worker or case manager may not be readily
available. Update the directory as often as needed to
provide accurate points of contact, locations, etc.
Know your community. Not just where you live but
the entire service area of your organization. Take a
drive and be aware of your surroundings. What do
you see on your commute? Be familiar with what
faith communities and other non-profit agencies
offer. Faith communities with farmer’s markets,
transportation assistance and health clinics are
available to serve their localities. Appreciation and
comprehension of what your patients, or customers,
experience is both enlightening and essential to
their health and wellness success.
Facilitating and offering resources is 50%
of the equation. The remaining initiative is on
the individual/family/caregiver. Therefore, it’s
sensible to offer resources that are specific to
their needs. Just giving a phone number may not
empower someone into action. A point of contact,
established appointment or assistance with required
documentation personalizes the assistance and
demonstrates that nurses meet people where they
are and recognize individual concerns.
As the interest in incorporating SDOH
for a more comprehensive view of patients is
addressed, community initiatives are dependent
on local funding and sustainable dollars. Success
depends on convincing the community and other
stakeholders that health disparities and inequities
are related to SDOH. SDOH can account for up to
40% of individual health outcomes (Booske, 2010).
That’s a significant number in our healthcare
environment where patient-centered care, the
patient experience and quality of life are identified
On the federal level, the Centers for Medicare
and Medicaid Services (CMS) wished to address the
connection between medical services and social
needs. Accountable Health Communities is a $157
million test payment mode, funding pilots, which
ask does addressing health-related social needs
reduce healthcare costs and utilization. Also, CMS
developed a 10-item screening tool to identify patient
needs in five different domains. The tool is designed
to be short, accessible, consistent and inclusive. The
domains are housing instability, food insecurity,
transportation needs, utility needs and interpersonal
safety (CMS, May 30, 2017). SDOH influence
readmission risk, increased utilization and affect
health outcomes. The National Academies of Science,
Engineering, and Medicine, acting on a request from
the Department of Health and Human Services,
convened to examine the SDOH elements that could
be considered for Medicare accounting purposes,
criteria to identify these factors, and methods
to do so in ways that promote health equity and
improve care for all patients (National Academies of
Sciences, Engineering, and Medicine, 2017). Medicare
Advantage plans are adding SDOH assessments and
benefits such as gym memberships, home-delivered
meals and friendly visitors.
Addressing SDOH with dual eligible Medicare
recipients, those that qualify for Medicare and
Medicaid, reveals that these patients have poorer
outcomes such as higher healthcare utilization,
higher healthcare spending, and lower quality
measure scores. Dual recipients report lower
educational attainment, a key SDOH. (Heath,
2019). More than half of dual recipients live in a
neighborhood where at least 20% of its inhabitants
live below the poverty level. Non-dual eligibles
experience better health, are more likely to have
higher education and are less likely to live with
diabetes, hypertension, heart failure or depression.
Other population-focused SDOH challenges are
experienced by the LGBTQ community, disabled
persons, homeless veterans and those living with
mental illness. Their healthcare may be impacted
by stigma and being a marginalized, vulnerable
individual. These individuals may have lower
incomes, fewer resources and complex health
conditions which when complicated with SDOH
result in poor health outcomes. Sensitivity to
individual experiences and needs is critical to
offering a superior patient experience.
Across our nation, partnerships are developing
to address SDOH. Many are between healthcare
organizations and community agencies. One
example is the local Agency on Aging and a
community hospital where they are addressing the
needs of older adults. Another is the Community
Service Board partnering with law enforcement and
the hospital emergency department for behavioral
health intervention. Other grassroot efforts focus on
specific needs with individual neighborhoods such
as street lighting, bike lanes and playgrounds.
Consider where people are born, grow, live, work
and play. Broadening nurses’ knowledge and skills
to include factors outside of traditional healthcare
services will truly address areas that impact selfcare
and healthy living.
Alley, D., Asomugha, C., Conway, P. et al. (2016).
Accountable health communities-Addressing social needs
through Medicare and Medicaid. http://www.nejm.org/
Booske, B.C., Athens, J.K. et al. (2010). Different
perspectives for assigning weights to determinants of
health. University of Wisconsin Population Health
Centers for Disease Control and Prevention (CDC) (2015).
Community health assessment & health improvement
Centers for Medicare and Medicaid Services (CMS), (2017).
Standardized screening for health-related social needs
in clinical settings. https://nam.edu/wp-content/
Fink-Samnick, E. (2019). The Social Determinants of Health:
Case Management’s Next Frontier. HCPro: Brentwood,
Hager, E. R., Quigg, A. M., Black, M. M., Coleman, S. M.,
Heeren, T., Rose-Jacobs, R., & Frank, D. A. (2010).
Development and validity of a 2-item screen to identify
families at risk for food insecurity. Pediatrics, 126(1),
Healthy People 2020. United States Department of Health
and Human Services. https://www.healthypeople.
Heath, S. (2019). Most Medicare dual-eligibles see
social determinants of health. Accessed at: https://
Institute of Medicine (March 2016). A framework for
educating health professionals to address the social
determinants of health. The National Academies of
National Academies of Sciences, Engineering, and
Medicine, (January 10, 2017). Accounting for
social risk factors in Medicare payment. http://
The Human Toll of Jail (2016). Incarceration’s impact on
kids and families. http://humantollofjail.vera.org/thefamily-jail-cycle/
World Health Organization, Commission on Social
Determinants of Health (2008). Closing the Gap in a
Generation: Health equity through action on the social
determinants of health. Available from: http://www.who.
Join Our Clinical Team at Compassus,
You’ll Remember Why You Do What You Do!
Now Hiring RNs & LPNs
Northern Virginia to Fredericksburg
If you are passionate about impacting patients’ lives through
compassionate hospice and palliative care, a position on our team
may be perfect for you! We offer medical benefits, 401(k) with
company match, generous PTO, and more lucrative benefits!
Visit our website to learn more about our amazing
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families, and to apply for our open positions:
Page 14 | February, March, April 2020
Virginia Nurses Today | www.VirginiaNurses.com
VNA/VNF Board Member
Appointed to Maternal
Health Strategic Planning
Are you a talented, innovative educator with a passion
to teach in a new BSN program in Central Virginia?
Full-time, 9-month position with tenure-track
(DNP, PhD) or non-tenure track (MSN)
for 2020-21 academic year
For more information, visit:
RNs (FT, PT, Day, Overnight)
Seeking Charge Nurses for residential dorms for children and adolescents.
The Barry Robinson Center is a premier behavioral health system
dedicated to improving the lives of children since 1933. We offer
residential treatment, outpatient services and foster care from our
campus in Norfolk, VA.
Must have associate degree in Nursing, VA license and a passion for psychiatric
nursing. Rotating weekends & holidays.
Great benefits – Medical, dental & vision, company 403(b) match,
tuition assistance, paid leave & sick time, paid life & long-term
disability insurance, and more.
Apply online via www.barryrobinson.org
In December 2019 Virginia Governor Ralph
Northam appointed Virginia Nurses Association and
Foundation board member Dr. Sherri Wilson, DNP,
MPA, RN to participate in a maternal health strategic
planning session. The purpose of the session was to
draft a set of statewide strategies to improve maternal
health in the commonwealth and meet the governor’s
goal to eliminate racial disparities in the maternal
mortality rate by 2025. Other participants included:
state agency staff, representatives of key stakeholder
groups, and women and family members who have
been or will be impacted by the issue.
Dr. Wilson is a public health nursing leader
in Fairfax, Virginia who specializes in maternal
and child health (MCH). Through her role as
Assistant Division Director for Health Services for
Fairfax County Health Department, she oversees
the planning, development, implementation, and
evaluation of public health services across multiple
clinics in Fairfax County with a focus on population
health and health equity.
In 2010, Dr. Wilson joined Kaiser Permanente
as an Operations Director. There, she impacted
systems-level change through the development of the
Regional Perinatal Service Center and the Early Start
program, a nursing outreach and care coordination
service addressing addictions in pregnancy and
obstetric populations with high-risk diagnoses and
co-morbidities. These programs improved health
outcomes by reducing the rates of preterm labor,
improving healthy behaviors, and reducing hospital
costs related to the length of stay.
Earlier in her career, Dr. Wilson served as the
director of maternal and child health services for
Prince George’s Hospital Center and also worked as
a public health nursing supervisor for the State of
Delaware, overseeing MCH programs. While in that
role, she was also assigned to staff and support the
Access to Care Committee for the former Lieutenant
Governor Carney’s Task Force for Health Disparities.
• Online RN to BSN
• Online RN to BSN to MSN
• Online MSN
- MSN in Patient Safety & Healthcare Quality
- MSN/MHA dual degree - MSN/MBA dual degree
www.VirginiaNurses.com | Virginia Nurses Today February, March, April 2020 | Page 15
Seeking Volunteer Applicants
for Mental Health First Aid
The Virginia Nurses Foundation recently received a grant from the Robert
Wood Johnson Foundation (RWJF) to support its mental health initiatives.
Among those initiatives, we will be underwriting the cost of one nurse to take
the Mental Health First Aid Instructor Training, Youth Module.
Research tells us that mental health distress is greater in economically
disadvantaged areas, so we will arrange for that nurse to subsequently present
the Mental Health First Aid, Youth Module Training on behalf of VNF in three such
communities. Our goal is to provide this free training to predominantly nurses
in these communities, with a special push for participation of school nurses and
nurses employed by health districts and community service boards. Non-nurses,
such as school guidance counselors, will also be encouraged to participate. The
instructor training is anticipated to take place during the 1st quarter of 2020,
with the three subsequent sessions occurring in the first six months of 2020.
If you have a passion for improving mental healthcare for our commonwealth’s
youth, and have not already participated in the Mental Health First Aid
Instructor Training, please complete our online form at https://form.jotform.
com/193495785591174 to be considered for this volunteer leadership role.
Though not a requirement, preference will be given to nurse applicants from
economically disadvantaged counties within the commonwealth.
Get Your Organization’s CE
Approved by VNA
The Virginia Nurses Association (VNA) is accredited as an approver
of nursing continuing professional development by the American Nurses
Credentialing Center’s (ANCC) Commission on Accreditation. Accreditation
as an approver allows VNA to approve other organizations to award nursing
contact hours for individual educational activities they are providing.
In the past year, VNA approved nearly 100 individual educational activity
applications to award continuing nursing education. VNA also approves
organizations, who demonstrate they have the structure and process to
consistently deliver nursing continuing professional development in adherence
to the ANCC criteria while monitoring outcomes, as Approved Providers. This
allows the Approved Provider organization to independently plan, implement,
and evaluate educational activities and award nursing contact hours during
a three-year approval period. In 2018, VNA’s Approved Provider organizations
provided more than 100,000 nursing contact hours. As an Accredited Approver,
VNA is able to contribute significantly to enhancing the quality and quantity of
nursing continuing professional development available to nurses across Virginia
and the country.
If your organization provides educational programming for nurses, you can
apply through the Virginia Nurses Association to award nursing contact hours.
The first step is to learn more about the individual activity application process
by visiting https://virginianurses.com/page/SubmitanIndividualActivity.
Organizations providing a large number of nursing educational activities may
also want to learn more about becoming an approved provider by visiting
VNA Director of Professional Development Lindsey Cardwell at Lcardwell@
virginianurses.com to learn more about how your organization can be approved.
Pay it Forward via VNF’s
Nightingale Legacy Fund
Nancy Littlefield, DNP, RN
Nurse Leadership Academy Steering Committee Member
In 2019, leadership of the Virginia Nurses Association and the Virginia
Nurses Foundation recognized an opportunity to greater support nursing
leadership development across the care continuum–everywhere nurses
lead. Nursing executives across Virginia came together to develop a year
long program called the Nurse Leadership Academy where high performing
nurses with less than five years of management experience could garner
exposure and immersion in key topics and therefore strengthen their
leadership core competencies.
The first six months of this year long program will be dedicated to live
didactic sessions and webinars. Participants will focus the subsequent six
months on their applied leadership project with virtual check-in points
along the way, with support from their mentor, who is chosen by the
candidate and has also committed to the success of their mentee and the
Additional coaching opportunities with program leadership and peerto-peer
engagement via a virtual community will round out the list of
resources aimed at ensuring every participant’s success. The program
culminates in month 12 with presentations from participants on their
applied leadership projects.
If you’re interested in enrolling in the Nurse Leadership
Academy, you can sign up for the waitlist at https://tinyurl.com/
Through hours of work and discussions, we couldn’t help but discuss
the impact that strong nursing leaders had in our own careers. Leaders
who are still present in our lives that we will ask to be speakers to help
teach the curriculum as well as leaders who we no longer work with but
when we look back we recognize they made such a significant impact on
us. How can we, through this leadership course, thank them for their
influence on us as well as their impact on nursing?
As a tribute to nursing leaders who have made a difference to us
and to help support the development of this important program,
we wanted to open up an opportunity for individuals to give to the
VNF Nightingale Legacy Fund. Monies donated will help support
the initial start-up of this leadership development program and
provide us with an opportunity to recognize and give tribute to those
we are thankful for because of the difference their leadership has
made to us.
Do you have someone you would like to honor because of the impact
that they have made to you as a nursing leader? Contributions will help
those taking the course to develop their own leadership skills and impact.
Donations can be made at https://tinyurl.com/ssfvp3c.
Virginia Cancer Specialists is
devoted to treating patients with the
best, most effective and advanced
therapies available today. As a part
of The US Oncology Network, we
deliver high-quality, evidence-based
care to patients close to home.
• 10 Convenient locations in northern Virginia
• State-of-the-art technology, innovative treatments, and extensive research
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• Monday-Friday schedule
• Medical, Dental and Vision
Join our team!
Please visit our website at
www.virginiacancerspecialists.com for our job postings.
Page 16 | February, March, April 2020
Virginia Nurses Today | www.VirginiaNurses.com
How to Write the Perfect Elevator Speech
An elevator speech is a brief, concise speech that tells who you are, what you
do, and what you want to achieve!* Use them to answer the questions “What do
you want and why should I care” in one minute or less. The goal is to plant a
seed of curiosity so as the elevator doors (real or metaphorical) open, the listener
says, “Tell me more.”
Elevator speeches should be short (30 seconds to one minute in many cases),
specific, and memorable!
Why are Elevator Speeches Useful to Nurses?
Any time you need to influence someone, you can use an elevator speech!
They are useful during job interviews, salary negotiations, performance reviews,
and in your LinkedIn profile or other social media to let everyone know what you
do for a living. We have found that a good elevator speech is particularly useful
when speaking with your legislators in support of nursing legislation.
Components of an Elevator Speech
When speaking with your legislator about issues related to nursing practice,
it is important to make sure your message is clear and that you avoid using
healthcare-specific jargon, as most legislators do not work in this field!
The Story and Key Data
The story/key data is where you can either use facts to enhance your
message or you can tell a personal story that relates to the problem you’re trying
to solve....or both! It’s important to remember that if you’re using data or facts,
you should be able to provide their reputable source. If you’re telling a personal
story, choose one that will leave a lasting impact.
The “ask” is perhaps the most important part of your elevator speech! This
is what you’re asking the listener to do. It might be an action you want them to
take, a position you want them to agree to, or even a candidate you’d like them
to vote for! Your ask should be clearly stated and easy to understand.
Issue: Protecting the Title of Nursing
Patients and families rightfully expect that health professionals who hold
themselves out as a nurse have received the legally required education and
training. To ensure this, we must maintain existing protections in the Code of
Virginia so that non-nurses are prohibited from using the term “nurse.”
The message is your main point or problem you’re trying to solve. You’re
stating what fact you’d like your listener to take away from your interaction.
At Southside Regional Medical Center (SRMC), we
believe that nurses are at the heart of healthcare.
Located about 25 minutes south of Richmond in
Petersburg, VA, SRMC is a 300-bed medical center
whose volumes are growing year after year. A
newer facility, advanced technology, award-winning
service lines and education assistance to further
professional growth are just a few of the reasons our
nurses say they like working here.
For information about job opportunities,
call 804-765-5790 or visit SRMConline.com.
Current Openings Include:
• Med/Surg (General, Oncology,
• Behavioral Health
• Emergency Department
• Free Standing Emergency
Sign-on bonus for select positions
An Equal Opportunity Employer
www.VirginiaNurses.com | Virginia Nurses Today February, March, April 2020 | Page 17
Restricting the use of the title “nurse” to only those who have
received the legally required education protects the public
from unqualified professionals. 39 states agree that a nurse
is a person who has completed required education, clinical
training, examination, and licensing requirements. We must
maintain existing protections in the Code of Virginia so that
non-nurses are prohibited from using the term. Can I count on
To access electronic copies of
Virginia Nurses Today, please visit
Issue: Ensure an Educated and Adequate Nursing Workforce
By providing financial incentives for healthcare professionals who serve as
uncompensated preceptors (hands-on clinical instructors) for APRN (advanced
practice registered nurses) students, we can increase access to care, address
the primary care shortage, handle mental health crises, and manage chronic
diseases. All of these factors are crucial in improving the health and wellness of
all Virginians. The incentive would be available for uncompensated preceptors,
including APRNs, physicians, and physicians’ assistants.
Experienced nurses and other health professionals serving
as preceptors are at the core of nursing education. We are
currently facing a preceptor shortage. Giving financial
incentives to uncompensated preceptors will help end the
shortage, and this will help increase access to care for many
Virginians. Will you support a tax incentive for uncompensated
preceptors, including APRNs, physicians, and physicians’
Western State Hospital
Opportunities available for RNs,
LPNs, & Psychiatric Nursing Assistants
• Psychiatric acute admissions units
• Psychiatric longer term units
• Med/Psych unit
Conveniently located in the Shenandoah
Valley, WSH affiliates with 9 Schools of
Nursing and major universities.
Nursing at Western State Hospital
Offers Excellent Benefits Including:
• Up to $7500 RN Sign On Bonus for New Hires
• Eligibility for Federal Loan
• Moving/Relocation Expenses
Reimbursement will be considered
• Unique Clinical Care Opportunities
• Ongoing Training Opportunities
• Educational Assistance
• Comprehensive Healthcare Benefits
• Group & Optional Life Insurance
• VRS Retirement Benefits
• Flexible Spending Account
• Paid Holidays, Vacation, Sick Leave
• Short & Long Term Disability Benefits
• State Employee Discounts
To submit your credentials for a career enhancing position, simply...
Visit jobs.virginia.gov, click “Search Jobs,” and under “Agency”
select “Western State Hospital” and click “Search.”
Western State Hospital : State psychiatric hospital licensed and operated
by the Virginia Department of Behavioral Health and Developmental Services.
Page 18 | February, March, April 2020
Virginia Nurses Today | www.VirginiaNurses.com
Top Seven Reasons to
become a VNA Member
1. Show commitment to your profession!
Membership in VNA makes a powerful
statement about you. It shows employers,
colleagues and your patients/clients your
commitment to nursing. Membership identifies
you as a nurse who is serious about the
profession as well as purposeful about staying
informed, educated and involved. Joining VNA
gives you an immediate connection to other
Virginia nurses, and a real sense of community.
2. Networking Opportunities
Members have opportunities for networking
on the local level at chapter meetings and on
the state level at our conferences throughout
the year. VNA offers many events throughout
the year allowing nurses across all spectrums
to network with their peers at a discounted
(and sometimes free) rates. These include local
chapter meetings and other regional events, as
well as our three annual conferences. These
events provide both continuing education and
opportunities for members to connect with local
and national leaders within the healthcare
industry to expand their professional networks.
We also have an online community our
members can utilize to network with their
fellow nurses without having to leave home!
3. Career and Leadership Development
Becoming actively involved with VNA not
only opens up educational and networking
opportunities, but can also help you hone
valuable leadership skills. Leadership roles
are available at both the local and state level,
as providing a variety of opportunities to
enhance leadership skill development. We’re
also constantly expanding our leadership
development opportunities through programs
like our soon-to-be launched Nurse Leadership
Registration opens soon for our 2020 Fall Conference,
Ending Incivility, Bullying, & Workplace Violence.
The conference will take place on Friday, September 25
and Saturday, September 26 at a new location:
the Renaissance Hotel in Portsmouth, Virginia.
www.VirginiaNurses.com | Virginia Nurses Today February, March, April 2020 | Page 19
Academy and the SYNC interprofessional
leadership program, both offered through the
Virginia Nurses Foundation.
4. Two memberships for the price of one!
When you join VNA, you alsobecome a member
of the American Nurses Association. For one
membership rate, you receive the membership
benefits of both organizations! More
importantly, you join with nurses across the
country as well as in Virginia, speaking with
one strong voice on behalf of your profession
and your patients.
5. Significant Discounts on Continuing
As a VNA member, you will have access to
free and discounted continuing education,
specialty journals, and our highly acclaimed
conferences! You already know how critical
these can be to your continuing competency,
which in turn can lead to better patient
outcomes, systems improvements, and personal
VNA has a variety of high quality educational
programming options to fit your busy schedule.
Much time and effort has been dedicated to
offering web-based CE modules available
on demand, and we also offer live-stream
distance-learning programs. All of these
learning opportunities are in addition to our inperson
conferences and chapter meetings. As
a CE provider, we continue to look for ways to
offer our members CE at a reasonable cost (and
in many cases, free).
Don’t forget: members receive a significant
discount on all continuing education
opportunities and receive access to membersonly
free online continuing education through
VNA and ANA.
6. Stay informed!
Stay up to date on the news and issues
affecting nursing through our free, members’
only publications and members’ only website
areas. Members receive exclusive access to
interviews, evidence based research, and much
Here’s a sampling of what our members receive:
• VNA News Brief,our weekly e-news – a
compilation of important national and
statewide news, relevant articles, and the
latest goings on at VNA.
• Virginia Nurses Today - Print and Digital
– beginning in May 2020, Virginia Nurses
Today is going green! All RNs will continue
to receive a digital version, but we will
continue to provide a print version of VNT
for members only!
• Legislative Updates – weekly email
briefs during the legislative session with
up-to-the-minute news on our legislative
• American Nurse Today —Monthly journal
(six print/six electronic) featuring peerreviewed
clinical, practical, practiceoriented,
career and personal editorial.
• OJIN—The Online Journal of Issues in
Nursing – Peer-reviewed, posted online
three times a year
• CINAHL® – access to a database with
more than 2.6 million records dating back
to 1981, covering nursing, biomedicine,
health sciences librarianship, alternative/
complementary medicine, consumer health
and 17 allied health disciplines.
• Navigate Nursingwebinars – webinars on
current and emerging topics provided free
or at significant savings to members.
7. We advocate for nurses!
Nurses make up the largest group of healthcare
providers in the state, and so it’s essential
that we have a voice in policy making and
engage in the political process. The perceived
time needed to engage in policy involvement
or development outside of daily “nursing work”
as well as the resources to develop skills
in policy participation has often hampered
nursing from becoming involved in advocacy.
Yet, when it comes to advocating on behalf of
nurses, VNA makes advocacy easy. We are the
only organization speaking for the 110,00+
nurses throughout Virginia. Our lobbyist,
leadership, and members work passionately to
educate our legislators and state policymakers
on issues crucial to the advancement of the
nursing profession. We update our members
weekly during our legislative calls and send
legislative e-blasts with breaking news during
the legislative session.