Montana Pulse - November 2020

November 2020 • Vol. 57 • No. 4 

THE OFFICIAL PUBLICATION OF THE MONTANA NURSES ASSOCIATION FOUNDATION 

Quarterly publication distributed to approximately 13,000 RNs and LPNs in Montana. 

ANA Excerpts 

Page 15 

State Wide Nursing News 

Page 16 

current resident or 

Non-Profit Org. 

U.S. Postage Paid 

Princeton, MN 

Permit No. 14 

Montana Nurses 

Association (MNA) is the 

recognized leader and 

advocate for the professional 

nurse in Montana and 

comprised of registered 

nurses including advanced 

practice registered nurses. 

MNA is a non-profit, 

member driven 

organization that has 

been in existence for 

over 112 years. MNA 

is the preeminent 

CEO Report 

MNA 2020 Highlights from the 

Chief Executive Officer 

Vicky Byrd, 

MSN, RN 

voice of the professional nurse in Montana at the local, 

state, and national level. MNA represents and advocates 

for nurses in relation to nurse competency, scope of 

practice, patient safety, workplace violence, professional 

development/continuing education, safe staffing, and 

improved healthcare delivery and access, just to name a 

few. 

The MNA staff fiercely advocates for quality continuing 

education and nurses’ right to collectively bargain, 

moreover, they are dedicated, loyal, and genuinely 

passionate regarding your profession and your 

professional nurse association. MNA remains the soughtafter 

voice for the professional nurse in Montana! 

CEO Report continued on page 3 

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Page 2 Montana Nurses Association Pulse November, December 2020, January 2021 

PUBLISHER INFORMATION 

& AD RATES 

Circulation 13,000. Provided to every registered 

nurse, licensed practical nurse, nursing student 

and nurse-related employer in Montana. The Pulse 

is published quarterly each February, May, August 

and November by Arthur L. Davis Publishing Agency, 

Inc. for Montana Nurses Association, 20 Old 

Montana State Highway, Montana City, MT 59634, 

a constituent member of the American Nurses 

Association. 

For advertising rates and information, please contact 

Arthur L. Davis Publishing Agency, Inc., PO Box 

216, Cedar Falls, Iowa 50613, (800) 626-4081, 

sales@aldpub.com. MNA and the Arthur L. Davis 

Publishing Agency, Inc. reserve the right to reject 

any advertisement. Responsibility for errors in 

advertising is limited to corrections in the next 

issue or refund of price of advertisement. 

Acceptance of advertising does not imply 

endorsement or approval by the Montana Nurses 

Association of products advertised, the advertisers, 

or the claims made. Rejection of an advertisement 

does not imply a product offered for advertising 

is without merit, or that the manufacturer lacks 

integrity, or that this association disapproves of 

the product or its use. MNA and the Arthur L. Davis 

Publishing Agency, Inc. shall not be held liable for 

any consequences resulting from purchase or use 

of an advertiser’s product. Articles appearing in this 

publication express the opinions of the authors; they 

do not necessarily reflect views of the staff, board, 

or membership of MNA or those of the national or 

local associations. 

WRITER’S GUIDELINES: 

MNA welcomes the submission of articles and 

editorials related to nursing or about Montana nurses 

for publication in The PULSE. Please limit word size 

between 500-1000 words and provide resources 

and references. MNA has the Right to accept, edit or 

reject proposed material. Please send articles 

to: jennifer@mtnurses.org 

If you wish to no longer receive 

The Pulse please contact Monique: 

mheddens@aldpub.com 

If your address has changed please 

contact Montana Board of Nursing 

at: www.nurse.mt.gov 

PULSE SUBMISSIONS 

We are gathering articles that are relevant 

and appealing to YOU as a nurse. What 

is happening in your world today? Is there 

information we can provide that would be 

helpful to you? The Pulse is YOUR publication, 

and we want to present you with content that 

pertains to your interests. 

Please submit your ideas and 

suggestions to Jennifer. 

Jennifer@mtnurses.org 

Enjoy a user friendly layout and access to more 

information, including membership material, 

labor resources, Independent Study Library, 

a new Career Center for Job Seekers & 

Employers, and more downloadable information. 

Please visit 

MNA’s constantly updated website! 

www.mtnurses.org 

CONTACT MNAF & MNA 

Montana Nurses Association Foundation 

and Montana Nurses Association 

20 Old Montana State Highway, Clancy, MT 59634 

• Phone (406) 442-6710 • Fax (406) 442-1841 

• Email: info@mtnurses.org • Website: www.mtnurses.org 

Office Hours: 7:30 a.m.-4:00 p.m. Monday through Friday 

VOICE OF NURSES IN MONTANA 

MNA is a non-profit, membership organization that advocates for 

nurse competency, scope of practice, patient safety, continuing 

education, and improved healthcare delivery and access. 

MNA members serve on the following Councils and 

other committees to achieve our mission: 

• Council on Practice & Government Affairs (CPGA) 

• Council on Economic & General Welfare (E&GW) 

• Council on Professional Development (CPD) 

• Council on Advanced Practice (CAP) 

MISSION STATEMENT – MNAF 

Preserve the history of nursing in Montana and contribute, support and 

empower the professional nurse in Montana. 

MISSION STATEMENT – MNA 

The Montana Nurses Association promotes professional nursing practice, 

standards and education; represents professional nurses; and provides 

nursing leadership in promoting high quality health care. 

PROFESSIONAL DEVELOPMENT 

Montana Nurses Association is accredited with distinction as an approver 

of nursing continuing professional development by the American Nurses 

Credentialing Center’s Commission on Accreditation. 

Montana Nurses Association is accredited with distinction as a provider 

of nursing continuing professional development by the American Nurses 

Credentialing Center’s Commission on Accreditation. 

MNAF & MNA 

Staff: 

Vicky Byrd, MSN, RN, Chief Executive Officer 

Pam Dickerson, PhD, RN, NPD-BC, FAAN, Director of Professional Development 

Kristi Anderson, MN, RN, NPD-BC, CNL Director of Professional Development 

Caroline Baughman, BS, Professional Development Associate 

Robin Haux, BS, Labor Program Director 

Amy Hauschild, BSN, RN, Labor Representative 

Leslie Shepherd, BSN, RN, Labor Representative 

Laurie Hunton, RN, Labor Representative 

Jill Hindoien, BS, Chief Financial Officer 

Jennifer Hamilton,Administrative & Marketing Specialist 

Board of Directors 

Executive Committee: 

Board of Directors President 

Board of Directors Vice President 

Board of Directors Secretary 

Board of Directors Treasurer 

Board of Directors Member at Large 

Board of Directors CPGA 

Board of Directors PD 

Board of Directors CAP 

Board of Directors EGW 

Lorri Bennett, RN 

Terry Dutro, MSN, APRN, AGPCNP-BC 

Chelsee Baker, BSN, RN 

Audrey Dee, RN 

Anna Ammons, BSN, RN, PCCN 

Cheryl Richards, Ed.D, RN-BC 

Lori Chovanak, DNP, RN, APRN-BC 

Brandi Breth, BSN, RN-BC 

Council on Practice & Government Affairs (CPGA) 

Gwyn Palchak, BSN, RN-BC, ACM Lisa Ash, RN, CNOR 

Sally Sluder, DNP, APRN, AGACNP-BC 

Loni Conley, BSN, RN 

Council on Professional Development (PD) 

Sandy Sacry, MSN, RN 

Megan Hamilton, MSN, RN, CFRN, NRP 

Gwyn Palchak, BSN, RN-BC, ACM Debby Lee, BSN, RN-BC, CCRP 

Emily Michalski-Weber, PMHNP-BC Abbie Colussi, RN 

Brenda Donaldson, BA, RN, CAPA Kim Reynen, BSN, RN 

Janet Smith, MN, MSHS, RN 

Council on Advanced Practice (CAP) 

Chairperson-CAP 

Deborah Kern, MSN, FNP 

Chairperson Elect-CAP 

Keven Comer, MN, FNP-BC 

Secretary-CAP 

Nanci Taylor, APRN 

Member at Large-CAP 

Terry Dutro, MSN, APRN, AGPCNP-BC 

Member at Large-CAP 

Emily Michalski-Weber, MSN, RN-BC 

Council on Economic & General Welfare (EGW) 

Delayne Stahl, RN, OCN 

Lorie Van Donsel BSN, RN, PCCN 

Adrianne Harrison, RN 

Questions about your nursing license? 

Contact Montana Board of Nursing at: www.nurse.mt.gov

November, December 2020, January 2021 Montana Nurses Association Pulse Page 3 

CEO Report continued from page 1 

Be an Active Voice in your State Professional Nurse Association through 

Membership 

MNA staff and nurse member leaders advocate and represent nurses through the 

professional association with governing councils and committees. All registered and 

advance practice registered nurses can (and should) belong to MNA, as it is first and 

foremost the professional association for all Montana nurses, moreover, MNA also 

enjoys additional recognition of advocacy through collective bargaining (if applicable 

to your situation). It is a professional commitment to our nursing profession as policy, 

practice, and work environments are ever changing. 

Legislation and other advocacy situations are currently supported by those registered 

nurse members paying membership dues, committing to their state professional 

association. One example is MNA’s ongoing “Your Nurse Wears Combat Boots” 

campaign. MNA continues to educate our legislators, our members, our employers, 

and our patients on the importance of workplace violence prevention for nurses and 

healthcare workers as we continue to push for protective legislation and standards. For 

these legislative, policy, and advocacy situations to happen, it is ok to pay dues and 

allow others to advocate for you. 

Your MNA membership which includes an ANA (American Nurses Association) 

membership for all members, an AFT-NHP (American Federation of Teachers-Nurses 

and Health Professionals) membership for those nurse members joining through 

collective bargaining, and an AANP (American Association of Nurse Practitioners) 

membership for our APRN members. Membership allows MNA to grow infrastructure 

and resources to invest in appropriate personnel (professional development, labor, 

lobbyists, legal, and health policy) for all professional nurses in Montana. MNA 

additionally invests resources back into the nurse members, financing their attendance 

to local, state, and national conferences and providing member support. 

MNA Succession Planning 

Succession planning is also playing a role at MNA. Our current Director of 

Professional Development, Pam Dickerson, PhD, RN, NPD-BC, FAAN, will be retiring 

around the end of this year, therefore we hired her replacement, Kristi Anderson, MN, 

RN, NPD-BC, CNL, in July to ensure adequate orientation and a seamless transition. 

Our part-time RN Professional Development staff will be transitioned into a full time 

Nurse Planner position slated to begin January 2021. Finally, our labor department filled 

their full-time labor representative position with Lauri Hunton, RN, who comes to us as a 

prior acute care staff nurse of 27 years. 

Covid-19 

Covid-19 pandemic has brought a new reality to MNA. Our educational offerings 

and meetings transitioned quickly to online via Zoom, GoToMeeting, and other digital 

platforms, keeping our staff and members as safe as possible. We have learned a 

lot from this transition, and we will be rethinking our advocacy and representation 

processes to work smarter and not harder. Additionally, we have been advocating 

for our local, state, and national leaders to embrace science and data while making 

decisions surrounding that evidence. MNA advocates for proper PPE (personal 

protective equipment) for all nurses and healthcare workers and adequate safety and 

public health measures to protect all citizens. Thank you to the many nurse members 

from around the state that recorded quick videos asking that everyone mask up. MNA 

continues to share those posts through Facebook. Finally, MNA has been in constant 

contact with DPHHS (Department of Health and Human Services) and the Governor’s 

office sharing our concerns and recommendations surrounding this pandemic. 

Relevance of Belonging to your State Professional Nurse Association 

Quoting one of our most beloved nurse’s, the late Mary Munger, RN: It is one thing 

to have been educated and licensed as an R.N., another to be employed as an R.N., 

but the mark of a real professional is a love for and interest in, what is happening to 

that profession, and a commitment to help it. Without taking this third step, without 

identification as a member of the professional nursing organization, many nurses are 

merely draining the good from the profession without adding their share to keep it 

strong and dynamic. (Munger, M. (n.d.). Membership: A professional commitment. 

Letter.) 

MNA is committed to the nurses and nursing profession in Montana and will 

always need the nurses’ commitment to keep it strong and dynamic, furthermore, 

to make decisions that will safeguard the future of the nursing profession. Activism 

is not for everyone but as nursing professionals, we must invest in our professional 

organization to ensure the infrastructure remains intact to carry our voices in all things 

that touch patients and nurses. 

Consider a Tax-Deductible Donation to: 

Montana Nurses Association Foundation-(MNAF) 

• Donations to the MNAF foundation are 100% tax deductible. 

• MNAF mission statement: “The Montana Nurses Association Foundation 

(MNAF) is the charitable and philanthropic branch of the Montana Nurses 

Association (MNA), with a mission to preserve the history of nursing in 

Montana and contribute, support and empower the professional nurse in 

Montana.” 

• The purposes for which the Corporation is organized are as follows: 

“(a) charitable; (b) educational; (c) to accept healthcare/nursing research and 

educational grants; (d) to provide continuing educational grants to licensed 

registered nurses; and (e) to award scholarships to qualifying persons.”


2020 MNA E lect ion Result s 

Treasurer 

January 2021-December 2022 

Director at Large 


Rep to the Board 

Prof. Develop 


Council of Prof. 

Development 


Audrey Dee 

RN 

Anna 

Svendson-Ammons 

BSN, RN, PCCN 

Deborah Lee 

BSN, RN-BC, CCRP 

Charlotte Skinner 

BSN, RN-C 


Development 



Development 



Development 



Development 


Brenda Donaldson 

BA, RN, CAPA, 

NPD-BC 

Janet Smith 

MN, MSHS, RN 

Abbie Colussi 

BSN, RN 

Joseph Poole 

BSN, RN, CHSE 

Rep to the Board 

CPGA 


Council on Practice 

& Gov Affair 



& Gov Affair 



& Gov Affair 


Tricia Thien 

RN, BAN, CGRN 

Paul Lee 

CCRN 


BSN, RN-C 

Melissa Anderson 

BSN, RN 

Visit nursingALD.com today! 

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Browse our online database of articles and content. 

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2020 MNA E lect ion Result s 

ANA Membership 

Assembly Rep 2 Yr 

ANA Membership 

Assembly Rep 2 Yr 

January 2021-December 2022 January 2021-December 2022 

Nominations 

Committee 


Nominations 

Committee 


Metta Barnhart 

BSN, RN 

Paul Lee 

CCRN 

Tricia Thien 

RN, BAN, CGRN 

Lorie Van Donsel 

BSN, RN, PCCN 

Nominations 

Committee 

Elections 

Committee 

Elections 

Committee 

Elections 

Committee 





Penny Haughian 

RN 

Lorie VanDonsel 

BSN, RN, PCCN 

Penny Haughian 

RN 


BSN, RN 

Chairperson Elect 

CAP Council 


Member at Large 

CAP Council 


Rep to Board 

E&GW 


Council on Econ 

& Gen Welf 


Margaret Hammersla 

BSN, MS, PhD, 

ANP-BC 

Deven Robinson 

MSN, FNP, PMHNP 

Brandi Breth 

BSN, RN-BC 

Delayne Stahl 

RN, OCN 

Council on Econ AFL-CIO Conven. AFL-CIO Conven. AFL-CIO Conven. AFL-CIO Conven. 

& Gen Welf 

Delegate 

Delegate 

Delegate 

Delegate 

January 2021-December 2022 January 2021-December 2021 January 2021-December 2021 January 2021-December 2021 January 2021-December 2021 

Adrianne Harrison 

RN 

Brandi Breth 

BSN, RN-BC 


BSN, RN 


BSN, RN-C 

Tricia Thien 

RN, BAN, CGRN


Legislative Panel Review 

MNA has experienced and witnessed how state and 

national lawmaking and policy can impact healthcare 

by the effects it has on nurses, patients, and our 

communities. We are each tasked with the civic duty 

to VOTE and cast our ballots, however, it is imperative 

NOW, more important than ever, to do so for our 

profession. Issues impacting our nursing profession 

range from much needed legislation addressing; staffing, 

accessibility to affordable healthcare, making it a felony 

to assault of a nurse or healthcare worker while on 

duty, maintaining our state sovereignty to regulate nurse 

licensure and the nurse practice act, fund our hospitals, 

and collaboration and inclusion of the nurses affected by 

the nurse licensure compact. 

Political party isn’t relevant. Purpose and 

support for MNA’s members’ issues are. 

On October 8, 2020, MNA held our biannual 

Legislative Panel. In order to address safety it was held 

virtually due to the COVID-19 pandemic. Our goal was to 

inform our members with important information regarding 

these issues when going to the ballot box. 

We invited EVERY candidate, regardless of Party for 

the races listed below. If you do not see a candidate 

listed, then we did not receive a response to our 

invitation. We want and NEED our lawmakers, more 

now than ever, engaged with MNA, as the recognized 

leader and collective voice for nurses across the state of 

Montana. 

To the candidates that joined our virtual event, we 

thank you for your participation and your willingness to 

answer questions important to our nurses’ profession. 

Nurses are public servants too and we appreciate 

their dedication to care for our citizens, especially during 

this pandemic. 

* U.S. Legislative Panel for Lawmakers on the 

National Level: 

U.S. Senate: 

• Steve Bullock (candidate) - attended in person 

• Steve Daines (incumbent) - responded and was 

unable to attend 

U.S. House of Representatives 

• Matt Rosendale (candidate) - attend in person 

• Kathleen Williams (candidate) - attend in person 

*SUMMARY OF THE QUESTIONS & ANSWERS 

WITH US SENATE CANDIDATE STEVE BULLOCK: 

Q1. Healthcare access and affordability for all, while 

maintaining essential health benefits and coverage 

for preexisting conditions remains a priority for 

MT nurses. Nurses support the ACA knowing it 

isn’t perfect but want to keep what works and fix 

what doesn’t. How do you envision your role to 

advocate at the national level for healthcare access, 

affordability, and protection of care for preexisting 

conditions? 

Join our amazing healthcare team 

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Apply online at jobs.corecivic.com 

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

Steve Bullock Answer: Have and will continue 

to advocate for affordable health care and maintain 

preexisting condition coverage; goal to negotiate 

prescription drug prices; recognize need for improvement 

of the AVA without a complete overhaul as an overturn 

will cause 90,000 Montanans to lose healthcare coverage 

Q2. Currently the United States lacks a coordinated state 

and national public health infrastructure with the 

capacity to respond to any large-scale infectious 

disease outbreak or other public health emergency. 

State and local public health departments have 

historically been severely underfunded and have 

been left to coordinate a response without national 

direction. How will you advocate on a federal level 

to develop regulations and systems, including 

adequate PPE supply to help combat or current 

pandemic situation and prevent future failures to 

protect healthcare workers and the public from an 

infectious disease, such COVID-19, or other public 

health emergency? 

Steve Bullock Answer: Recognize the lack of federal 

support for PPE and need national testing and a unifying 

message; need to address the PPE supply chain and 

ship it out to facilities that need it; will advocate for a 

united national response and provide national leadership 

Q3. Collective bargaining rights. Federal decisions 

have stripped away collective bargaining rights 

for public employees all across the US, to weaken 

the collective voice of workers, professional nurses 

included, that greatly impact the ability to advocate 

for safe quality working conditions affecting patients 

and patient care. How will you ensure collective 

bargaining rights for the Montana professional 

nurse to form and/or join a union, are not further 

weakened? 

Steve Bullock Answer: As a previous labor lawyer 

who worked with multiple unions and know the battle; 

supports the right organize and collectively bargain at 

both the federal and state levels; organized labor helps 

all so needs to be easier to organize; will fight “Right to 

Work”….which really means “right to work for less” all 

around 

Q4. Currently 16 states have addressed, on some level, 

presumptive eligibility for workers compensation 

insurance for frontline health care workers during 

the COVID-19 pandemic. How do you plan to 

advocate for this MUCH needed protection in MT 

for our MT frontline healthcare workers? 

Steve Bullock Answer: This exact issue was a 20 

year fight for firefighters to get this passed in Montana; 

YOU HAVE THE 

POWER TO FIGHT FLU! 

The best way to prevent seasonal influenza 

is to get vaccinated every year. 

PROTECT YOURSELF AND THOSE 

AROUND YOU. VACCINATE: 

- Yourself 

- Your patients 

- Your family 

For more information visit: 

immunization.mt.gov 

we have to stop putting your members in danger and 

they need to be protected; if there is something that can 

be done on a federal level for this issue, I will support and 

advocate for this. 

*SUMMARY OF THE QUESTIONS & ANSWERS 

WITH US HOUSE OF REPRESENTATIVE 

CANDIDATES MATT ROSENDALE AND KATHLEEN 

WILLIAMS 

Q1. Healthcare access and affordability for all, while 

maintaining essential health benefits and coverage 

for preexisting conditions remains a priority for 

MT nurses. Nurses support the ACA knowing it 

isn’t perfect but want to keep what works and fix 

what doesn’t. How do you envision your role to 

advocate at the national level for healthcare access, 

affordability, and protection of care for preexisting 

conditions? 

Matt Rosendale Answer: Preexisting conditions is 

important to him as he has a sister who had brain cancer 

and regardless of the ACA, would like to protect this and 

reduce premiums. 

Kathleen Williams Answer: Against repealing the 

ACA because to protect preexisting conditions you need 

to protect the ACA; can’t repeal ACA and hope to protect 

preexisting conditions; will advocate for people 55 and 

older to buy into Medicare 

Q2. Currently the United States lacks a coordinated state 

and national public health infrastructure with the 

capacity to respond to any large-scale infectious 

disease outbreak or other public health emergency. 

State and local public health departments have 

historically been severely underfunded and have 

been left to coordinate a response without national 

direction. How will you advocate on a federal level 

to develop regulations and systems, including 

adequate PPE supply to help combat or current 

pandemic situation and prevent future failures to 

protect healthcare workers and the public from an 

infectious disease, such COVID-19, or other public 

health emergency? 

Matt Rosendale Answer: Need to focus on 

restoring national levels of PPE and support the voice 

to address PPE issues; needs to be collaborative and to 

develop a solution 

Kathleen Williams Answer: National response 

was frustrating to me; need more forward thinking and 

strategic leader in Congress; should not repeal ACA; 

need to make sure there is access to and enough of the 

reagent needed COVID-19 testing 

Q3. Collective bargaining rights. Federal decisions 

have stripped away collective bargaining rights 

for public employees all across the US, to weaken 

the collective voice of workers, professional nurses 

included, that greatly impact the ability to advocate 

for safe quality working conditions affecting patients 

and patient care. How will you ensure collective 

bargaining rights for the Montana professional 

nurse to form and/or join a union, are not further 

weakened? 

Matt Rosendale Answer: most important to 

not strip away rights of workers; supports earning 

full capacity of earnings with certifications; did not 

specifically state support of collective bargaining 

Kathleen Williams Answer: Support collective 

bargaining and middle class with higher pay and better 

benefits; voted and “Right to Work” (note: law that 

weakens the collective bargaining rights for nurses); 

supports safe working conditions for all healthcare 

workers and need to protect collective bargaining rights 

for the future 

* Montana Legislative Panel for Lawmakers on the 

State Level: 

Governor & Lt. Governor 

• Gianforte-declined, not willing to share a time slot 

with other candidates 

• Mike Cooney/Casey Schreiner-attended in person 

• Lyman Bishop/John Nesper-confirmed to attend, 

but did not show up


Superintendent of Public Schools 

• Kevin Leatherbarrow- confirmed to attend, but did not show up 

• Melissa Romano-attended in person 

• Elsie Arntzen-responded unable to attend 

Secretary of State 

• Christi Jacobsen- confirmed to attend, but did not show up 

• Bryce Bennett-attended in person 

Attorney General 

• Raph Graybill-attended in person 

• Austin Knudsen-no response 

State Auditor 

• Troy Downing- confirmed to attend, but did not show up 

• Shane Morigeau-attended in person 

• Roger Roots-no response 

*SUMMARY OF THE QUESTIONS & ANSWERS WITH GUBERNATORIAL 

CANDIDATE MIKE COONEY/CASEY SCHREINER (only candidate that 

participated) 

Q1. Our public health departments and nurses are working diligently during this 

pandemic to protect our communities. How will you advocate to develop 

regulations and systems, including our PPE situation, to help prevent an 

inadequate pandemic response and properly protect healthcare workers and 

the public from an infectious disease, such COVID-19, or other public health 

emergency? 

Cooney/Schreiner answers: At onset of COVID-19, jumped on phone and 

spent hours trying to find PPE and found MT was competing with other states; way 

fed government had this set it up was backwards; stockpile better now; bottom line… 

need to continue this effort; need to protect our local public health departments so 

they can stay local have tools to do to make the decision they need to make…will stand 

up against leg that attempts to strip rights away from our public health departments 

Q2. The late Mary Munger, RN a public health nurse and MNA member until her 

passing last year, championed the 1960’s legislative bill, titled to this day “The 

Blue Eyed Nurses Bill” after her beautiful blue eyes, that allows professional 

nurses to stick together to bargain collectively, can we count on you to vote down 

any effort to weaken any collective bargaining rights for our Montana nurses? 

Why or why not? 

Cooney/Schreiner answers: YES! Support right to collectively bargain and 

negotiate working conditions; will veto any attempt to strip collective bargaining rights 

Q3. Currently 16 states have addressed, on some level, presumptive eligibility for 

workers compensation insurance for frontline healthcare workers during the 

COVID-19 pandemic. How do you plan to advocate for this MUCH needed 

protection during the 2021 Legislative session, should a bill be introduced, in MT 

for our MT frontline healthcare workers? 

Cooney/Schreiner answers: supports partnership with local health officials; we 

need healthy workers to help get our economy up and running again and need to 

protect frontline workers; we would help shepherd a bill on this topic this through and 

work together with Republicans and Democrats; we showed this with our fire fighter 

friends last session (NOTE a similar bill was passed in 2019 for fire fighters) 

*SUMMARY OF THE QUESTIONS & ANSWERS SUPERINTENDENT OF 

PUBLIC SCHOOLS CANDIDATE MELISSA ROMANO (only candidate that 

participated) 

Q1. Protecting public education and access to quality education is an important priority 

for our communities. What are your thoughts on funding public schools and not 

allocating public funds to private and/or charter schools and why is this important 

to you? 

Romano answers: Want to put the “public” back into the Superintendent of 

“Public” Schools; advocates for public tax dollars to go to publics schools; public 

money should not be diverted to fund private schools and taken away from those who 

need it most 

Q2. Since last March when COVID-19 sent our kids home from school, their lives have 

been drastically changed. With the re-opening of schools and our current surge in 

COVID-19 cases across the state how will you ensure all public schools have the 

supplies, tools, and staff they need to keep kids and school staff safe? 

Romano answers: Safety is top priority; schools need to have all the available 

resources for safety and for our new way of learning; will be a leader and source of 

support of all local schools districts so they can stay safe obtain resources they need 

*SUMMARY OF THE QUESTIONS & ANSWERS WITH SECRETARY OF STATE 

BRYCE BENNETT (only candidate that participated) 

Q1. If elected, how will you ensure continuing voting access, either by mail or in person, 

for all Montanan’s? 

Bennett answers: Supports a bi-partisan approach; will push back on any voter 

oppression; supports ability to vote by mail 

Q2. Voting rights are under attack nationwide, including in Montana, however on 

September 25, 2020 the court permanently struck down a Montana law that 

restricted voting rights of Native Americans. The case of Western Native Voice v. 

Stapleton, challenged a law that imposed sever restrictions on ballot collection 

efforts that are critical to Native American voters living on rural reservations. How 

will you protect ballot collection efforts in the future for all rural communities? 

Bennett answers: Voted against this bill because it was voter suppression and 

make it hard for certain Montanans to cast a ballot; restricted voting rights and does 

not support this; proud to push back and support the ability for voting access for 

Native Americans; this is neighbors helping neighbors and will make sure every vote is 

counted 

*SUMMARY OF THE QUESTIONS & ANSWERS WITH ATTORNEY GENERAL 

CANDIDATE RAPH GRAYBILL (only candidate that participated) 

Q1. Over the past 3 leg sessions, the MNA has spearheaded a violence against 

nurses and healthcare workers campaign called “YNWCB.” Although we have 

yet to get felony Legislation passed or any increased penalty, can you provide 

suggestions for nurses who are assaulted at work, to advocate for an assault 

charge with our city and county attorneys? 

Graybill answers: This is a big priority for me; assault against frontline healthcare 

workers is an egregious crime; the atty general can supervise the county attorney 

and makes sure they take these cases seriously 

Q2. The late Mary Munger, RN a public health nurse and MNA member until 

her passing last year, championed the 1960’s legislative bill, titled to this 

day “The Blue Eyed Nurses Bill” after her beautiful blue eyes, that allows 

professional nurses to stick together to bargain collectively. What role do you 

see the Attorney General playing in protecting collective bargaining rights for 

Montanans? 

Graybill answers: Supports protections of collective bargaining rights to provide 

leadership and advocacy; understands there is a war against the right to collective 

bargaining in the court system….using the courts to attack these rights; worked with 

Gov. Bullock and went to supreme court to work to protect these rights; will run an 

office that provides real leadership and supports workers. 

*SUMMARY OF THE QUESTIONS & ANSWERS WITH MONTANA STATE 

AUDITOR SHANE MORIGEAU (only candidate that participated) 

Q1. What ideas do you have for increasing access to affordable health insurance for 

all Montanan’s? 

Morigeau answers: Need to educate and inform all Montanans on health 

insurance rights are and what fraud looks like; want to work with hospitals and 

all players for need transparency in healthcare costs and protect from fraud with 

insurance companies and securities. 

Q2. With the high cost of prescription drugs impacting many Montana families, what 

ideas do you have regarding affordability of prescription drugs in our state? 

Morigeau answers: We need elected officials willing to work together to combat 

rising cost of prescription drugs; need to stop price fixing; need transparency in these 

drug costs so people know what they are getting and they need access to the drugs 

they need


2020 E&GW Annual Report 

I am excited to share all the work your MNA 

Labor Department has been doing. With member 

engagement, organizing (both internal and external), 

and labor education continuing to be priorities for our 

department, our goal is to improve the nurse collective 

voice across Montana as it is the most powerful voice! 

We are excited to welcome Lauri Hunton, as our 

newest Labor Department team member! Lauri 

started in July and became interested in working for 

MNA as she was a part of her nurse bargaining team 

at Community Medical Center. All three of our labor 

representatives are nurses now! 

Your MNA Labor Representatives, Amy Hauschild, 

RN-BSN, Leslie Shepherd, RN-BSN continue to 

represent and assist all our local bargaining units. 

COVID-19 has drastically changed how our staff works 

with our locals and we have definitely embraced this 

new, and accepted, virtual world. A positive side-effect 

has been how available our staff can be and this will 

be an approach we will continue to use far beyond 

COVID-19. 

An important component to embracing our virtual 

world will be our investment into technology, educating 

our nurses, and encouraging participation. Our nurses 

have the ability to participate from wherever they may 

be and this has been an exciting engagement tool. 

As a collective bargaining unit nurse, your 

engagement is of utmost importance to success at the 

bargaining table. Participate in meetings and surveys, 

support your bargaining teams, and stay engaged! 

2020 Council Reports 

This action can be as little as providing food for your 

bargaining team to helping distribute support stickers 

or badges, or whatever you decide to make it! Every 

little bit helps build your voice! Advocacy through 

bargaining and collective action can, and does, make 

impacts at the bargaining table. As we continue to 

strengthen our contracts, we continue to improve the 

workplace for our nurses. 

We encourage each of our nurses to reach out to 

just ONE new nurse and share with them why they 

value their own professional nurses union. Engaging 

our younger nurses will be key to maintaining the 

nursing collective voice and improving the workplace. 

Over the next year, we will be providing new education 

for officers, grievance and resolution training, and new 

member orientation. We look forward to seeing all of 

you either by web camera or in person! 

Remember to follow us on Twitter at @MTnurses 

and like us Facebook and thank you for all the work 

each of you do every day advocating for patients 

across Montana! 

2020 PD Annual Report 

The overarching goals of the Council on 

Professional Development are congruent with the 

mission of MNA – to promote professional nursing 

practice, standards, and education and to provide 

nursing leadership in promoting high-quality health 

care. Specifically, these goals are: 

1. Provide quality continuing nursing education 

that supports the mission of MNA, following 

guidelines as an accredited provider by the 

American Nurses Credentialing Center’s 

Commission on Accreditation. 

2. Approve educational activities and provider 

units that support nursing professional 

development and improvement in patient care 

and/or nursing practice, following guidelines 

as an accredited approver by the American 

Nurses Credentialing Center’s Commission on 

Accreditation. 

As required by accreditation criteria, there are 

outcome measures associated with both provider 

and approver unit operations. Increasingly, there is 

emphasis on validating the importance of continuing 

nursing education in improving the professional 

practice of nursing. Evidence of the excellence of our 

work in this area includes designation of Accreditation 

with Distinction of our accredited provider and 

approver units. 

Council on Professional Development: 

The Council typically meets twice a year for faceto-face 

meetings in addition to conference calls for 

new member orientation and other issues as required. 

A virtual meeting was held in 2020. Some members 

of the council focus on provider unit operations and 

activities; other members serve as peer reviewers 

for the approver unit. Peer reviewers undergo initial 

education and testing, as well as periodic validation 

of competence to ensure their ability to assess 

applications congruently with peer reviewers across 

the United States and appraisers in the ANCC Nursing 

Continuing Professional Development Accreditation 

Program. Some of our peer reviewers are not 

members of the Council but have extensive experience 

as nurse planners in their own organizations. 

Approver Unit: 

The MNA Accredited Approver Unit accepts 

applications from both individual activity applicants 

and organizations wishing to be approved, or to 

continue their approval, as providers. Individual 

activities are approved for up to two years once all 

accreditation program criteria have been met. Provider 

units are approved for up to three years, with authority 

to design, implement, and evaluate their own activities 

under the leadership, direction, and accountability of a 

Primary Nurse Planner during that period of time. The 

Approver Unit monitors quality and outcomes from 

both individual activity and approved provider data in 

accordance with accreditation program criteria. Our 

approver unit is recognized as a leader by ANCC’s 

Nursing Continuing Professional Development 

Accreditation Program, resulting in receipt of referrals 

for applicants from around the country and around 

the world. The approver unit operates under the 

leadership of the Nurse Peer Review Leader, who 

also serves as the MNA Director of Professional 

Development. We currently have 35 approved 

providers and approve approximately 150 individual 

activities per year. 

Provider Unit: 

The MNA Accredited Provider Unit is accountable 

for planning, implementing, and evaluating all 

continuing nursing education offered by MNA. This 

includes annual events such as the Transition from 

New Graduate to Professional Nurse workshop, the 

APRN Pharmacology Conference, Nurse Advocacy 

Retreat, CE Provider Update workshops, Convention, 

and the interprofessional Seamless Health Care 

for Our Veterans conference. Additionally, the 

provider unit offers a number of in-person and webbased 

educational activities. While the main target 

audience of provider unit activities is MNA members, 

educational activities are open to all nurses interested 

in our events. The www.cnebymna.com web site is 

populated with independent study opportunities in the 

areas of professional development, clinical practice 

development, and continuing education provider 

education. The provider unit operates under the 

leadership of the Lead Nurse Planner, who also serves 

as the MNA Director of Professional Development. 

Continuing education continues to be a major 

benefit to membership and provides numerous 

opportunities for nurses to enhance their professional 

development as learners, faculty, authors, peer 

reviewers, and activity planners. Additionally, as part


of MNA’s commitment to improve the professional 

development of our members and volunteers, we 

support the participation of members of our Council 

on Professional Development in national professional 

development events. This is the second year of our 

focus on supporting the professional development of 

nurses through certification. MNA has contracted with 

ANCC to use the Success Pays® program, offering 

an incentive to MNA members to take the certification 

examination at no cost – the fee is paid only if/when 

the nurse passes the examination. Our agreement with 

ANCC requires that a minimum of 20 RNs successfully 

apply for certification within the 12-month contract – 

we surpassed that requirement in the first six months 

of the program! We received an award from the ANCC 

SuccessPays ® program in 2020 for our “conversion 

rate” – the number of applicants who actually achieved 

certification. 

Evidence clearly supports the value and importance 

of nursing professional development to sustain 

lifelong learning and contribute to the nurse’s ability 

to be successful and effective as a clinician, educator, 

researcher, or administrator. We are proud to support 

professional development through our nationally 

recognized accredited provider and approver units. 

2020 CAP Council Annual Report 

MNA has asked our Governor to help get a 

proclamation signed for nurse practitioner week 

November 8-14, 2020. Our governors have done this 

yearly as our communities greatly benefit from our 

APRNs enjoying full practice and prescriptive authority, 

moreover, having the ability to practice to the fullest 

extent of their education. A special shout out to our 

Nurse Practitioners who practice as public health 

and primary care providers especially during a global 

pandemic. 

MNA works continuously with our two national 

affiliates (ANA and AANP) to advocate for policy 

and legislation that benefits our APRNs. Below is 

collaborative work with these affiliates as we opposed 

the recent APRN licensure compact editions. 

ANA’s advocacy opposing the 2020 proposed 

APRN Compact practice hours provision. 

It imposes costly and unnecessary legislative 

and regulatory requirements for supervision 

for an unsubstantiated number of hours, 

jeopardizing the goal of facilitating APRNs as 

full contributors to the interprofessional team 

and creation of a more effective and more 

responsive healthcare system. 

AANP’s advocacy opposing the 2020 proposed 

APRN Compact practice hours provision. 

The political landscape that was present when 

the NCSBN initially undertook their independent 

revisions of the APRN Compact has significantly 

changed. NCSBN’s position that advancing the 

APRN Compact will require taking a page from 

organized medicine’s playbook was not the right 

solution when they proposed it last summer. 

Likewise, it is not the right step now and will not 

help our nation recover from a pandemic, and 

decades of similarly unnecessary regulations 

that have hindered patient access to safe, 

quality APRN care and needlessly driven up 

healthcare costs. Now more than ever, patients, 

regulators and state governments need the 

Nursing community to uphold the principles of 

the APRN Consensus Model and coalesce on a 

version of the APRN Compact that is workable 

and we all can endorse and advance. 

Unfortunately, the NCSBN delegates did pass 

this revision in August of 2020 and our MT Board of 

Nursing had two delegates that participated in the 

NCSBN convention. Our APRNs concerns were 

communicated to them prior to their votes. MNA did 

request (in full transparency) how our delegates voted 

on these revisions to the APRN compact and MNA 

was not provided an answer. 

MNA sees their role as a professional commitment 

to our nursing profession as policy, practice, and 

work environments are ever changing. In support 

and commitment to our APRNs MNA provides our 

APRNs with an MNA/ANA membership and now will 

include an AANP membership at no further cost. Dues 

support the infrastructure to invest into our members, 

legislative efforts, practice and policy support, and 

collective bargaining where applicable. 

Membership at all levels allows MNA to grow their 

infrastructure and resources to invest in appropriate 

personnel (professional development, labor, lobbyists, 

legal) for all nurses in Montana. MNA additionally 

invests resources back into the nurse members, 

financing their attendance to local, state, and national 

conferences. 

2020 CPGA Annual Report 

It is one thing to have been educated and licensed 

as an R.N., another to be employed as an R.N., but 

the mark of a real professional is a love for and 

interest in, what is happening to that profession, and a 

commitment to help it. 

Without taking this third step, without identification 

as a member of the professional nursing organization, 

many nurses are merely draining the good from the 

profession without adding their share to keep it strong 

and dynamic. (Munger, M. (n.d.). Membership: A 

professional commitment. Letter.) 

It is now more important than ever to be involved 

at all policy and legislative levels as this affects our 

licenses, practice, and patients. MNA is committed to 

the nurses and nursing profession in Montana and will 

always need the nurses’ commitment to keep it strong 

and dynamic, furthermore, to make decisions that will 

safeguard the future of the nursing profession. 

Activism isn’t for everyone but as nursing 

professionals we must invest in our professional 

organization to ensure the infrastructure remains intact 

to carry our voices in all things that touch patients and 

nurses. 

Our 2020 MNA House of Delegates unanimously 

approved our Legislative Platform (below) that drives 

our advocacy for policy and legislative change. 

2020-2021 MNA Government Relations Platform 

Montana Nurses’ Association (MNA) is the nonprofit 

professional association representing the voice of 

nearly 18,000 Registered Nurses (RNs) in Montana 

including more than 1000 licensed as Advanced 

Practice Registered Nurses (APRNs). MNA is the 

recognized professional organization, which lobbies 

for nursing practice issues to protect the practice of 

professional nurses and also protect the public in all 

areas of health care. 

MNA is the recognized leader and advocate for the 

professional nurse in Montana. 

MNA Mission Statement: The Montana Nurses 

Association promotes professional nursing practice, 

standards and education; represents professional 

nurses; and provides nursing leadership in promoting 

high quality health care. 

1. Improve the quality of nursing practice by: 

a. Providing educational opportunities that 

contribute to improving practice competency 

and quality of patient care. 

b. Identifying and pursuing funding sources 

to assist in providing continuing nursing 

education. 

c. Identifying and pursuing funding sources 

that support research/projects to develop 

evidence based and innovative nursing 

practice. 

d. Promoting national certification of registered 

nurses. 

e. Active representation on local, state and 

national advisory committees/boards. 

f. Supporting the regulatory authority and 

collaborating with the Montana Board of 

Nursing (BON) on nursing practice and 

regulatory issues. 

g. Encouraging transparency and promoting 

communication from the Montana Board of 

Nursing regarding relationship with NCSBN 

and votes affecting regulation of registered 

nurses 

h. Input into the implementation of NCSBN 

Nurse Compact Licensure legislation. 

i. Oppose the NCSBN eAPRN Nurse Compact 

Licensure legislation. 

2. Protect the economic and general welfare of nurses 

by: 

a. Actively engaging in legislation and campaigns 

that positively contribute to the economic and 

general welfare of RNs. 

b. Ensuring the right of RNs to engage in 

collective bargaining in Montana. 

c. Opposing any “Right to Work” legislation now 

being referred to as “NO RIGHTS AT WORK” 

by MNA. 

d. Addressing workplace environment issues 

including violence against healthcare workers, 

safe staffing, and patient safety. 

e. Advocating legislation prohibiting mandatory 

overtime. 

3. Improve access to quality, cost effective health care 

by developing and/or supporting public policies 

which: 

a. Respond to the needs of the unserved and 

underserved populations by promoting access 

to health care and healthcare coverage. 

b. Identify or develop alternative health care 

delivery systems that are cost-effective and 

provide quality health care. 

c. Mandate third party reimbursements directly 

to RNs from public and private payers. 

d. Remove barriers (financial, governmental, 

regulatory, and/or institutional) that deny 

access to appropriate/qualified health care 

providers and approved medical standard of 

care treatments. 

e. Advocate for legislation that is transparent 

and bipartisan and support policies that 

can achieve evidence based real healthcare 

reform. 

f. Promote community and world health by 

collaborating with other health professionals to 

promote health diplomacy and reduce health 

disparities. 

4. Protect human rights by developing and/or 

supporting public policies which: 

a. Promote access to appropriate health 

services. 

b. Preserve individual rights to privacy. 

c. Promote, debate and have consideration of 

ethical dilemmas in health care 

d. Protect nurses and healthcare employees 

and the public at large from public health 

emergencies. 

5. Protect the environmental health of individuals and 

communities through: 

a. Acknowledging, supporting and addressing 

environmental impacts on the health of 

Montanans. 

b. Actively engaging with national organizational 

affiliates in addressing environmental health 

issues in our nation. 

c. Identify the nurse’s primary commitment is 

to the patient, whether an individual, family, 

group, community, or population. 

6. Protecting and promoting the future healthcare and 

nursing practice through: 

a. Actively engaging in legislation that supports 

professional scope of nursing practice to the 

full extent of individual education and training. 

b. Actively promoting programs and efforts 

that encourage educational progression of 

professional nursing at state and national 

levels. 

c. Representation on boards, committees and 

advisory groups which influence the future of 

the nursing profession and the future of our 

state and national healthcare system. 

d. Engaging with healthcare partners and 

associations to work collaboratively to 

ensure healthcare as a right for all American 

populations. 

e. Actively support science and evidence based 

data to drive strong investment in safe quality 

public health programs at state and national 

levels. 

MNA Board and House of Delegates approved 

10/2020


2020 MNA Awards 

Submitted by: Robin Haux and Amy Hauschild 

Distinguished Nurse of the Year Award: 

I would like to nominate Leesha Ford, MSN, RNC-OB, CNE, for the 

Distinguished Nurse of the Year Award. Leesha consistently demonstrates 

dynamic leadership in promoting excellence in nursing through her service on 

the Montana Board of Nursing, her leadership in MSU College of Nursing on 

various committees and the AFMSU bargaining team, her community service as 

leader in building Toby’s House, a child abuse prevention respite nursery, Alluvion 

Board member, and Kiwanis Club President. She always demonstrates a keen 

knowledge of current issues in the nursing profession, and is widely respected 

by her peers, patients, and students. She is one of the most ethical nurses I have 

ever known, has risen from AD to RN to MN, and respects all levels of nursing, 

clients from all backgrounds. She is a team worker and collaborator, and models 

positive quality improvement. She ran for the Legislature in 2018, against a 

strong Republican incumbent. I thoroughly expect she will run again in the future. 

Submitted by: Laurie Glover, MNA Member 

Friend of Nursing Award: 

Montana local health department staff have worked tirelessly throughout 

the COVID-19 pandemic. Each and every public health staff member (nurses, 

administrative staff, temporarily hired staff, health officers, and sanitarians) in 

jurisdictions large and small, have spent long hours to protect the health and 

safety of their community from this virus. Their efforts have prevented countless 

infections from overwhelming our healthcare systems. A current estimate of staff 

dedicated to COVID-19 public health response across the state is approximately 

Awe Kualawaache 

Care Center 

Where History and Healing come together 

HIRING LPNs & RNs 

Sign on Bonus! 

Awe Kualawaache Care Center located across from 

the Big Horn Battlefield. We offer not only a career 

but culture and caring. 

We hire people, not resumes. 

But we also expect excellence, 

which is why we require: 

• Graduate of an accredited school of nursing, required 

• Bachelor of Science in Nursing (BSN), preferred 

• Current/valid R.N.or L.P.N. license from the state licensing 

board, required 

• Current BLS endorsed by the American Heart Association or 

ACLS certification, required 

• Minimum of one (1) year of related experience. 

275 people. The number of staff on the local level shifts on a daily basis as they 

hire new people and rotate volunteers that provide assistance. 

The primary achievement of these professionals is the preservation of 

the public health in the face of great adversity. This response has required 

many midnight phone calls and off-hours tasks. They have demonstrated 

professionalism in the face of adversity. Some have ill loved ones they are 

working hard to protect, and some have lost family and friends to the virus. Still, 

they keep working and keep hoping there is an end in sight. 

The protection of healthcare workers has been a primary objective from the 

beginning. While shortages existed, local health departments worked with 

their local facilities to provide personal protective equipment and guidance on 

the optimization of its use. Local public health departments work with facilities 

to screen, test, and exclude those who are ill to protect their patients and 

coworkers. 

I am so proud to work with all these wonderful people. They are anxious, too, 

but have shown a level of professionalism and dedication to the communities 

they serve that I never imagined possible. One nurse continued to assist during a 

surge in their community while her father lay dying of COVID-19. Though she did 

take time to be with her family, she set aside her grief to help with the many tasks 

affiliated with managing COVID-19 in a populace. 

The fight is not over. Local public health will have to transition to a new 

phase of the operation when vaccine becomes available. COVID-19 will not last 

forever, and the strain of working through this crisis may cause an exodus out 

of the public health community. A staffing turnover in several jurisdictions during 

this event has already been observed. It is important to honor their work and 

sacrifice, and I appreciate the opportunity to submit this unusual nomination. 

Submitted by: Jennifer Miller RN, CPH 

Economic & General Welfare Council (E&GW) Achievement Award: 

All Rocky Mountain Clinic RN’s deserve this award! 

On February 14, 2019, the nurses at the Rocky Mountain Clinic in Butte, 

Montana held their election to vote to form their nurse’s union. All 12 nurses 

voted and all 12 nurses voted YES! They were excited to get ready and begin 

the bargaining process, however the Rocky Mountain Clinic has refused to 

recognize the nurse’s union, whose main goal is to protect their paid time off and 

to advocate for their patients. The employer has chosen to ignore the request 

to bargain and instead spent inordinate amounts of money to fight these twelve 

nurses by forcing them to file four unfair labor practices. Currently, the Employer 

is fighting the legal certification by the National Labor Relations Board (NLRB) all 

the way up to the Washington, D.C. Circuit Court. MNA does not know exactly 

how much money the Employer has spent fighting these twelve nurses, yet, but 

we believe it far exceeds protecting a few days off and a voice for 12 nurses to 

advocate for their patients. 

The MNA Economics and General Welfare Council wants to recognize the 

strength these nurses have shown and commend them for sticking together! 

They are supporting each other so they can solidify their collective voice to better 

advocate for each other and their patients. Stay strong Rocky Mountain Clinic 

nurses and know you have all the MNA nurses behind you! 

To learn more or to download an 

application visit: akcc2.org 

Awe Kualawaache Care Center | 10131 South Heritage Lane 

Crow Agency, MT 59022 | 406-638-9111


Labor Reports and News 

I’m So Thankful for 

Our Union 

Recently, one of our union 

members called me to ask 

advice on how to handle some 

issues which had arisen in her 

workplace. This nurse has 

been a member of her MNA 

Local Unit for quite some time. 

After we strategized about the 

issues at hand and steered 

her in the right direction- in 

this case, I suggested she 

reach out to another local 

leader in another part of 

the state who had recently 

experienced a similar situation 

and successfully remedied it. 

Amy Hauschild, 

BSN, RN, Labor 

Representative 

This nurse went on to tell me how thankful she is 

for her local unit and having the ability to collaborate 

with professional nurses from all over the state, 

not only about local unit issues, but also questions 

about patient care, safety, standards, any issue the 

professional nurse may encounter. She said, “Some 

people think the union is here just to protect our rights 

at work and be there in case something bad happens, 

but unionism is more than that.” She is correct. At 

MNA, we are bringing people together to create power 

to advocate for what they decide is in their common 

interest, for their common good and for the good of the 

patients for whom they serve. 

Many of you who know me personally can attest 

that I have often said “You are just one change away 

from your worst nightmare at work.” MNA will always 

be there for our nurses on the job when they are 

experiencing challenges. However, the true power of 

the collective comes from the unity and cohesiveness 

the nurses create themselves while advocating for their 

patients and themselves. It’s hard to imagine a world 

where a nurse may be labeled a troublemaker or even 

targeted after raising a practice or safety concern, but I 

have seen it first-hand. When nurses call MNA and ask 

for help organizing themselves into a union, the primary 

reason is usually not related to pay or benefits, they are 

looking for the collective voice and the ability to safely 

and effectively advocate for their patients. 

It is especially important during these 

unprecedented times, that we remain united! Please 

reach out to your labor representative with any 

questions/problems. 

I have been working at 

MNA for over three years 

now. The time has zipped 

right on by. In my time 

working with and advocating 

for nurses, I have come 

to realize, accept, and 

appreciate that YOU are the 

union. It is you, the nurses, 

who have the power to 

identify issues and drive 

change, not me. 

I have been steadily 

working with each of my 

locals over the past three 

years to encourage communication, autonomy, and 

advocacy. In some, these are built into the structure of 

their Local. In others, we have had to build it together. 

As a registered nurse, I have witnessed processes in 

my locals that both inspire me and leave me asking, 

“Why?” 

It is those processes that both shock and puzzle 

me where most of the advocacy begins. Problems 

identified by members, brought forward for closer 

YOU are the Union 

Leslie Shepherd, 

BSN, RN, Labor 

Representative 

inspection, lead to taking steps towards positive 

change. It is an amazing accomplishment for you as 

nurses to be change agents within your facilities. As 

front-line workers, you all can trouble shoot and come 

up with the most simple and ingenious solutions. 

The key to this process lies in YOU the NURSE 

identifying the issue. Even with the best of intentions, 

I am merely an outsider looking into your work 

processes and conditions. What I identify as a high 

priority item, may be completely different than what 

you as nurses doing the work would identify. You are 

the union. You are the eyes and ears. What you see 

and deal with everyday drives what changes your 

union can affect. 

Nurses have the strength to stand together to 

create positive change in their workplaces. You 

have the power to bring issues to light and be a 

change agent where you work. I find myself grateful 

to the nurses who bring these matters forward, who 

drive change. Keep bringing issues forward. Keep 

advocating for what matters to you. Together, you all 

are the strength of your union. 

An IHS Career - we offer an extraordinary opportunity to provide 

comprehensive care in culturally rich Native American Indian and Alaska 

Native communities throughout 37 states. 

To access electronic copies of the 

Montana Pulse, please visit 

http://www.nursingALD.com/publications 

While Indian health practices focus on primary care and family practice within the 

communities we serve, our care is comprehensive. There is a need for patient care in a 

wide range of units and shifts. The units include the following, those indicated with an 

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Intensive Care 

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Lead Nurse 

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Nurse Educators 

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Nurse Specialist 

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Recruitment and/or relocation incentive(s) may be authorized. Loan repayment opportunities available. 

For more information, contact us at ihsrecruiters@ihs.gov


Labor Reports and News 

Why I became a Labor Rep. 

Recently I have switched careers. I have been 

a nurse for 28 years, an RN for 14 years and have 

worked in acute care my whole career. My passion 

was to care for moms and babies, and I loved it. I 

have found my passion has changed these past few 

years. That passion has switched to advocating for 

my colleagues. As nurses, we are expected to be at 

the top of our game to care for, advocate and protect 

our patients, but who is here for us? Well, your union. 

Your union is here to keep you safe, advocate and 

protect you. 

All Montana Nurses Association union nurses have 

rights! The Supreme Court’s Weingarten decision 

gave you the right to representation. Always ASK 

Lauri Hunton, RN, CCBE 

Labor Representative 

for a Union Representative, Local Representative, Resolution Officer, or any 

Union member at your workplace. You have the right for a second set of eyes 

and ears at a meeting that may result in discipline. 

Know your Weingarten Rights! Before discussing your Weingarten 

Rights, you must understand what an “investigatory interview” is. An 

investigatory interview is when you are questioned by your manager or 

director about any issue that you are, or may have been, involved with 

that could possibly lead to disciplinary action. This can include tardiness, 

overtime, patient complaints, peer complaints, etc. You should ask at the 

beginning of the meeting, “Is this a meeting that can lead to disciplinary 

action?” If they answer “Yes” then you have the right to ask for representation. 

If they say “No” and indicate that you do not need anyone, listen carefully to 

what is being discussed. If it starts to feel like it could lead to discipline, you 

have the right to invoke your Weingarten rights. 

Know the Rules! Weingarten Rights are invoked when an investigatory 

interview occurs, these rules apply. 

1. The employee must make a clear request for union 

representation before or during the interview. The employee cannot be 

punished for making this request. (Note: Do not ask the employer, “do I 

need union representation?” It is up to you to make the statement that 

you want union representation.) Remember, management is not an 

appropriate representative, so if they offer you the nursing supervisor or 

someone else to sit with you, that is not adequate. You either need a local 

unit leader, a steward or grievance officer, or any other member to act as 

your representative and you have the right to a reasonable amount of time to 

obtain representation. 

2. After the employee makes the request, your employer must choose 

among three options. The employer must either: 

1. Grant the request and postpone any further questioning until a union 

representative arrives and has a chance to consult privately with the 

employee; or 

2. Deny the request and end the interview immediately; or 

3. Give the employee a choice: 1) having the interview without 

representation, 2) ending the interview. 

*If your employer denies your request for union representation and 

continues to ask you questions, this is considered an unfair labor practice 

under the law. If this occurs, you have the right to refuse to answer and 

you cannot be disciplined for a refusal to answer questions without union 

representation. Remember to say “I will listen, but I will not provide any 

comment until I can get union representation.”* 

When you are wondering: “Do I need representation?” The answer is yes 

you do. Your representative cannot disrupt the interview, but they are on the 

same level at this meeting as management is. Management must allow them 

to speak and ask questions. 

Nurses always have the responsibility to care for, advocate and protect 

their patients. Rights are in place to help, advocate and protect nurses as 

well. Please know and understand your rights and be aware of the protections 

that are included in your collective bargaining contracts. Also, know who your 

Officers and Representatives are, they are here to help represent you and 

your contract. 

When Your Employer Notifies You of a Meeting... 

*Immediately ask your Supervisor/Manager/Director: 

• “What is the purpose of the meeting?” 

• “Is the meeting investigatory?” 

• “Will I be asked questions which may possibly lead to discipline?” 

• “Will I be asked questions which require me to defend my conduct?” 

CONGRATULATIONS TO THE FOLLOWING NURSES WHO HAVE 

TAKEN ADVANTAGE OF THE SUCCESS PAYS OFFERING BY ANCC 

TO MNA MEMBERS! 

Rashall Jones, RN-BC – Medical Surgical Nursing 

New Member Benefit: MNA now offers certification 

through ANCC’s Success Pays ® Program 

> Reduced fee for MNA Members to obtain initial certification 

or recertify 

> No cost if you don’t pass the exam; you can also take the 

exam a second time at no cost 

> Pay only when you pass! 

> Identify your specialty practice area 

How Success Pays ® Works 

> Visit nursingworld.org/our-certifications/ to: 

• Make sure you’re eligible to sit for the exam 

• Look at the test blueprint and test preparation materials 

• Make the decision to move forward 

> Visit www.mtnurses.org and click on Success Pays ® option 

to the left and sign up for the program! 

> MNA will contact you regarding how to get the benefit. 

If the meeting is investigatory or answers may 

lead to discipline: 

__#1 – Respectfully inform your employer you are invoking 

your Weingarten Rights & will need to have your Union/Unit 

Representative or Nurse Advocate present during questioning. 

__#2 – Quickly arrange for your Union/Unit Representative or 

Nurses Advocate to attend the meeting. 

Weingarten Rights 

If this discussion could in any way lead to my being 

disciplined or terminated, or affect my personal 

working conditions, I respectfully request that my 

Union/Unit Representative or Nurse Advocate be 

present at this meeting. 

Until my representative arrives, I choose not to 

participate in this discussion


Professional Development Department 

During this unprecedented time of uncertainty, it is 

important that we focus on our own self-care as nurses. 

Self-care looks different for each person and might 

include exercise, meditation, or simply spending time 

with family. If we pay attention to our own emotional, 

psychological, and physical responses to stress, we are 

better able to apply strategies to relieve stress. As we are 

navigating through this difficult time, consider ways that 

you can implement self-care behaviors. Ensuring that we 

care for ourselves is vital in our roles as nurses. 

Provision 5 of the ANA Code of Ethics for Nurses 

states, “The nurse owes the same duties to self as to 

others, including the responsibility to promote health 

and safety, preserve wholeness of character and 

integrity, maintain competence, and continue personal 

and professional growth” (ANA, 2015, p.19). From this 

statement, self-care and health promotion is a duty of the 

nurse. We model professionalism and represent standards of quality in our work. 

Practicing self-care behaviors assists in maintaining our own health while being a 

role model for others. 

There are several resources available to help support you: 

• CNEbyMNA https://cnebymna.com/online-courses/ 

o Free CNE online learning 

s Article included self-care approaches with reflection questions 

• What Would Florence & Her Colleagues Do? 

o Low cost CNE online learning 

s Dealing with Moral Distress and Ethical Dilemmas 

s Nurse Burnout: Exercise and Sleep 

s Nourishment to Combat Health Stressors 

s Wellness Breaks 

s And more! 

Importance of Self-Care for Nurses 

Kristi Anderson, 

MN, RN, NPD-BC, CNL 

Director of Professional 

Development 

• ANA: Covid-19 Self-Care Package for Nurses https://www.nursingworld.org/ 

continuing-education/anas-covid-19-self-care-package-for-nurses/ 

o Free CNE online learning 

s Nursing Ethics: Strategies to Resolve the Top Ethical Dilemmas Nurses 

Face 

s Moral Resilience 

s Dealing with Fatigue: Strategies for Nurse Leaders 

s Promoting Nurse Self-Care: Emotional and Mental Wellbeing 

s A Nurse's Guide to Preventing Compassion Fatigue, Moral Distress, and 

Burnout 

o Additional Mental Health Support Services 

• National Academy of Medicine https://nam.edu/initiatives/clinician-resilienceand-well-being/ 

o Resources on clinician well-being and resilience during the COVID-19 

outbreak 

Saying Good-Bye – 

With Best Wishes and a HUGE 

Thank You! 

It has been an honor and privilege for me to work 

with MNA staff, leadership volunteers, and members 

over the past nine years. It has been exciting to watch 

and participate in the growth of the organization, the 

advocacy initiatives in which we’ve been involved, and 

the energy that is created when a group of registered 

nurses are dedicated to promoting and supporting their 

profession and their colleagues. 

I will be retiring in December. Kristi Anderson, MN, RN, 

NPD-BC, CNL, who has assumed the role of Director of 

Professional Development, will also become the Lead 

Nurse Planner for our ANCC Accredited Provider Unit 

and Nurse Peer Review Leader for our ANCC Accredited 

Approver Unit. Kristi has been on board at MNA since 

early July and is well on her way to becoming proficient in 

these roles. 

Pam A. Dickerson, 

PhD, RN, NPD-BC, FAAN 

Director of Professional 

Development 

As we move into what I hope will be a calmer and healthier 2021, I wish you well 

– individually and as an organization. MNA is a strong voice for nurses in Montana, 

and has a powerful national presence as well. This is only possible because of 

those who are passionate about the profession, care about their colleagues, and 

have a commitment to continuing professional development. Best wishes for a 

bright future!


Professional 

Development 

Department 

Montana Nurses Association 

Approved Providers 

APRN Corner 

APRN PHARMACOLOGY 

CONFERENCE 2021 

Save the Date 

MARCH 5TH & 6TH, 2021 

MNA thanks all of the Approved Provider Units we work with for their 

commitment to advancing and promoting quality nursing practice through 

continuing nursing education. 

Acute Care Education 

Vancouver, WA 

Alaska Native Tribal 

Health Consortium 

Anchorage, AK 

Alaska Nurses Association 

Anchorage, AK 

Alzheimer’s Resource of Alaska 

Anchorage, AK 

Bartlett Regional Hospital 

Juneau, AK 

With Distinction 

Benefis Healthcare Systems 

Great Falls, MT 

Billings Clinic 

Billings, MT 

Boise State School of Nursing 

Boise, ID 

Bozeman Health 

Bozeman, MT 

Cardea Services 

Seattle, WA 

Caring for Hawai’i Neonates 

Honolulu, HI 

Central Peninsula General Hospital 

Soldatna, AK With Distinction 

Community Medical Center 

Missoula, MT 

Confluence Health 

East Wenatchee, WA 

Evergreen Health 

Kirkland, WA 

Foundation Health Partners 

Fairbanks, AK 

Kalispell Regional Healthcare System 

Kalispell, MT 


Midland Memorial Hospital 

Midland, TX 

Montana Geriatric Education 

Center of UM 

Missoula, MT With Distinction 

Montana Health Network 

Miles City, MT 

Montana VA Health Care System 

Helena, MT 


Mountain Pacific Quality Health 

Helena, MT 

North Valley Hospital 

Whitefish, MT 

Pacific Lutheran University 

Tacoma, WA 


Planned Parenthood of the Great 

Northwest and the Hawaiian Islands 

Seattle, WA 

Providence Alaska Learning Institute 

Anchorage, AK 

Providence Healthcare 

Spokane, WA 

South Dakota Nurses Association 

Pierre, SD 

South Peninsula Hospital 

Homer, AK 


St. Luke’s Health System 

Boise, ID 

St. Peter’s Health 

Helena, MT 

St. Vincent Healthcare 

Billings, MT 

UF Health Shands Hospital 

Gainesville, FL 

Wisconsin Nurses Association 

Madison, WI With Distinction 

I had the opportunity to spend a recent Saturday in a NP 

policy meeting and wanted to share some 2020 changes. 

Many of you might already be aware, but never hurts to share 

again. 

1. 2020 Medicare Physician Fee Schedule final Rule 

started January 1, 2020 - All APRNs, PAs and 

Physicians may review and verify, rather than redocument 

notes entered into the medical record made 

by Physicians, Residents, APRNs, PA and Nursing 

Students. This applies to all professional services in 

all settings. So, I hope this encourages you all to take 

students in your settings. 

2. CMS clarified that NPs, CNSs and PAs are authorized to 

certify for home health services effective March 1, 2020 

Keven Comer 

MN, APRN, FNP-BC 

and bill for home health certification (part of the CARES Act) – this is permanent 

law. Montana’s state laws are congruent with this implementation. If you have any 

problems ordering or certifying home health services, please reach out ASAP so 

we can get it fixed. 

3. Medicare testing coverage for COVID – Medicare will cover the first COVID-19 

diagnostic without a clinician order, but all subsequent diagnostic tests will require 

an order 

4. SNF NPs authorized to perform the initial visit and all other mandatory visits. – 

duration of the public health emergency (PHE) waivers—in accordance with state 

law. 

5. If you haven’t implemented telemedicine into your day-to-day care, please do. It is 

reimbursed well, and patients love it. 

I am finding it hard to believe we are all going into our 9th +++ month of the COVID 

pandemic—and by the time you are reading this even longer. I hope you are all doing 

well and have taken time to spend time with family and take care of yourself. These are 

challenging times that will forever change the way we care for ourselves and our patients. 

Lets use our collective hearts and minds to make it great. Reach out if you have any 

practice issues. 

NEW MEMBER BENEFIT FOR APRN’s 

If you are an APRN, membership to Montana Nurses Association (MNA) includes 

three professional memberships for one low membership rate. 

• MNA – Montana Nurses Association 

• ANA - American Nurses Association 

• AANP – American Association of Nurse Practitioners 

If you are currently an MNA member who is also an APRN, please e-mail Jill at jill@ 

mtnurses.org so she can sign you up for your AANP membership or if you have any 

questions. 

Kootenai Health 

Coeur d’Alene, ID 


www.cnebymna.com 

NursingALD.com can point you 

right to that perfect NURSING JOB! 

NursingALD.com 

Free to Nurses 

Privacy Assured 

Easy to Use 

E-mailed Job Leads 

Be sure to check out our CNEbyMNA 

Website for Continuing Education 

opportunities. Sign up for upcoming 

events and online learning courses. 

It is constantly updated with new 

Webinars and Courses for your 

continued learning! 

*Montana Nurses Association 

is accredited with distinction as 

a provider of continuing nursing 

education by the American Nurses 

Credentialing Center’s Commission on 

Accreditation* 

$15.00 $15.00 

What is Your 

Learning 

Environment? 

see more 

$15.00 $15.00 

Transitions of 

Care: 

Interfacility 

Transfers 

see more 

Performing 

a Quick and 

Helpful Physical 

Assessment 

see more 

Quick Review of 

12-lead ECG 

see more


ANA Excerpts 

Healthcare Crisis/ACA/Medicaid 

Expansion – OPINION by Loni Conley 

As a nurse currently 

working in Public Health as 

a COVID Case Investigator, 

I see an immediate need in 

our state for more staffing, 

testing supplies, and 

PPE. Early detection and 

notification is crucial to how 

we can limit disease spread, 

by knowing who is actively 

or potentially infectious and 

guiding them through that 

process. The only way to 

achieve early detection and 

notification is with enough 

healthcare staff and enough 

testing supplies. 

Loni Conley, RN 

Candidate, 

Montana State 

Legislature 

Even prior to this pandemic, our chronic healthcare 

staff shortages have presented a balancing act for 

maintaining quality patient care. With the current 

surge of COVID-19 cases in Montana, and flu 

season beginning, we need to anticipate greater 

staffing shortages in our healthcare facilities and 

other essential workforces. Our hospitals are 

already experiencing maximum patient census and 

short staffing. Our long-term care facilities can’t 

provide quality care if they have multiple staff out on 

quarantine. 

As of today, October 11, we have 286 patients 

hospitalized for COVID-19 related reasons in our state. 

PPE supplies for MT healthcare facilities are continually 

inventoried and will likely not be enough, should cases 

continue to rise at this same rate. Every essential 

worker in our state from Browning, Missoula, Dillon, 

or Miles City deserves adequate PPE and payroll 

protection. 

Our healthcare staff, teachers, first responders and 

other workforces will need financial security when they 

are required to isolate or quarantine in order to protect 

their patients, students, and customers. I urge you to 

write to Senator Daines and ask him to vote in favor 

of passing the HEROES act. The HEROES act will not 

only provide needed financial security, but also allow 

us to purchase testing supplies and PPE in order to 

get one step ahead of disease spread and make sure 

Montanans stays healthy, employed, and taking care 

of one another. 

We need strong leadership from those who work 

in healthcare which is exactly why am asking for the 

Senate to pass the HEROES act. I am running for state 

legislature because I believe those working the front 

lines and bedsides should have a seat at the table. 

There is a saying that “nurses make the worst 

patients” and it’s true, because we want to stay 

healthy enough to take care of our patients and each 

other! 

Share Your Clinical Excellence and 

be a Part of Montana Health 

Network’s Professional Team! 

• Flexible Scheduling 

• Lucrative Salary 

• Travel Reimbursement 

• Varied Shifts or short/long contracts 

• Housing while on travel assignment 

• Bonuses – End of year and end of 

extended contracts, if qualified 

Great Falls College MSU is seeking a part-time Nursing Faculty 

member to join the team for our Nursing Programs (ASN and PN). 

BSN required, MSN preferred, State of Montana RN licensure, and 

two years of experience required. 

Excellent benefits package • Summers and Holidays off 

Learn more about our 

Nursing Programs at: 

gfcmsu.edu/webs/nursing/ 

To Apply Online, please visit: 

jobs.gfcmsu.edu 

NEED EXTRA INCOME? 

• Health Insurance 

• 401 (k) Plan 

• Professional Liability Insurance and 

Worker’s Compensation 

• $100,000 Accident Insurance 

Now recruiting Clinical Professionals 

for Full time, Part time, and Per diem 

• RN • CNA 

• LPN • Radiology Tech 

Apply online at: www.montanahealthnetwork.com 

or contact David Perry, RN - Staff Coordinator/Director of Nursing Services 

406-852-6361 or 406-228-8044 | contact@montanahealthnetwork.com 

Disabled/AA/EEO/Vet Preference Employer


State Wide Nursing News 

WORKPLACE FRATERNIZATION 

NURSING ADMINISTRATOR/ 

LEADER ROLE 

You were (or will be) hired 

to do a nursing administrator/ 

leadership job! That means 

that you are trusted and 

considered competent to 

make difficult, logical, fair, and 

progressive decisions. You 

might have a board of trustees 

(or other advisory people) to 

make decisions. Because you 

are the nursing administrator/ 

leader, you (especially you) 

are legally accountable for 

Carolyn Taylor 

Ed.D, MN, RN 

your decision-making role and behavior for the welfare 

of patients and nursing staff. The most effective 

and accurate decisions on your part are (or will be) 

an outgrowth of your leadership knowledge and 

intellectual skills (cognitive domain), your leadership 

ability and function skills (psychomotor domain), 

and your selected attention skills (affective/feeling 

domain). Therefore, it is imperative to understand, 

perform leadership, and relate to the psychology of 

human behavior. Understanding fraternization and 

its implications are to understand human behavior. 

It is this awareness that helps to identify nursing 

professional prowess. 

Fraternization is when coworkers act socially 

with each other or are inappropriately friendly 

with each other in the work situation; therefore, 

disrupting job expectations. 

It is common for frequent interactions with 

coworkers to lend themselves naturally to friendly 

relationships. After all, getting along with coworkers 

increases work morale. The very practice of nursing 

encourages work fraternization. Also, after-hour 

romantic relationships are easily a part of the work 

setting—with good or bad results. Conversations 

with nurses to explain how romantic or other social 

relationships can negatively impact work can be a part 

of orientation and in-service content. 

Nursing leadership objectivity requires no influence 

by personal feelings or opinions as to the facts 

regarding work fraternization. Therefore, the big 

objective questions for a nurse administrator/leader 

are-- 

1. How is it made abundantly clear to nursing 

staff about the boundaries to mitigate potential 

fraternization problems? 

2. What are the ways to help nurses remain 

focused on nursing process tasks during 

their work time and as indicated by their job 

descriptions? 

TEACHING AND LEGAL ENFORCEMENT OF 

FRATERNIZATION 

The work policy should state that the facility/ 

organization supports positive work relationships in 

the common interest of quality nursing care and the 

meeting of job description expectations. However, 

there is non-acceptance of inappropriate fraternization 

and consequences for obvious infractions. A copy 

of this policy is provided to each nursing employee. 

The policy will help mitigate potential fraternization 

problems. Policies are written and distributed 

as standard operating procedures (SOP) of the 

organization. 

A job description is separate from a policy 

statement. Job descriptions follow the Benjamin 

Bloom Taxonomy (online)—each positive expectation 

started with an action verb and related to one of 

the three domains of cognitive, psychomotor, and 

affective/feelings. Job descriptions are the positive 

statements that are the internal guidance systems of 

the facility/organization. 

Reprimand for disruptive employee fraternization 

should be progressive. First, start with a verbal 

warning or private discussion. The second time 

fraternization occurs, present the employee with a 

written notification. The third time (the final time), give 

a written statement of transfer or job termination. 

Something like—three strikes and you are out concept. 

Be sure that the policy clearly states the progression 

of employee fraternization warnings and the outcome 

of persistent non-compliance. Always have legal 

documents (including original facility/organization 

policies) signed and dated by both the nursing 

administrator/leader and the employee. 

WORK VS. PUBLIC BEHAVIOR—A NURSING 

LEADER CHOICE 

Nursing administrative/leadership behavior means 

that you are aware of and CHOOSE the professional 

conversation and action that you share in the workplace 

with the nursing staff. 

There are three behaviors--“public/social behavior,” 

“private behavior,” and the “work behavior.” You, as 

a nursing administrator/leader, must decide how to 

communicate to the nursing staff to keep these three 

behaviors under control. The public/social behavior 

and private behavior most often will not successfully 

get nursing accomplished in the manner designated 

by the job description. It also means that every nurse 

must learn there is a time and place that legitimately 

supports the changing of the communication climate 

from work behavior to private, public, or social behavior. 

The separation of these three behaviors represented by 

nursing leadership communication (words and actions) 

will help assure more meaningful attention to successful 

professional work behaviors. Family and friends will 

benefit when the work behavior stays at work. Patients 

benefit when work behaviors occur on the job. Knowing 

and practicing outstanding leadership behavior helps 

control the on-the-job social behavior of fraternizing and 

maximizes positive work behavior on the job. 

The consequences of sharing personal (private) 

information are not always or not all bad. Sharing 

selected unique commonalities may be a good thing 

if you try to establish a close working relationship 

with another person. However, maintaining a nursing 

administrative/leadership role and positive influence 

with nursing staff requires some restraint. The problems 

of excessive personal or private sharing by a nurse 

administrator/leader with any nursing employee 

can lead to possible attempts of nurse employee 

manipulation, blackmail, or misrepresentation of the 

shared comments to others in an untoward manner. 

Before sharing your personal or private information 

as a nurse administrator/leader, the question you 

should ask yourself: “How could this information be 

misconstrued, misused, or how could it be used against 

me as a nurse administrator/leader?” If this concern 

appears to represent paranoid thought— so be it for 

your good! Believe it or not—not all of your cohorts and 

subordinates have your best interest in mind all of the 

time! 

Furthermore, the personal and private sharing 

(inappropriate fraternization) between nursing 

employees during work hours is time-consuming, 

distracting, and non-productive for getting the nursing 

assignments done. 

BENEFICIAL UNCERTAINTY (WATCHFUL 

UNEXPECTED EYES) 

When trying to curtail inappropriate fraternization 

among employees, being close to employees at 

unexpected moments will tell you if a nursing employee 

is on task. Your presence as an unpredictable nursing 

administrator/leader watching job performance is 

called BENEFICIAL UNCERTAINTY. In other words, 

they (nursing staff) never know for sure when a nursing 

administrator/leader will unexpectedly be present 

or show up! Interesting—social communication and 

inappropriate fraternization often increase when the 

nursing administrator/leader leaves for the day! Have 

you ever noticed or have times when there is a shift 

from nursing behaviors to unacceptable fraternization 

behaviors? Time to pay unexpected attention--and 

watch behavior improve! 

VERBAL NON-JUDGEMENTAL RECOGNITION OF 

FRATERNIZATION 

If you notice a fraternizing behavior that deviates 

an employee from expected work performance, 

merely draw verbal attention to your observation of 

inappropriate fraternization without drawing judgment 

on the observed fraternization. Draw attention to the 

unacceptable fraternizing behavior by simply saying 

what you observe without judging the behavior. Then, 

listen to the personal judgment he/she places on their 

fraternizing behavior. You, as a nurse administrator/ 

leader, allow the nurse to verbally or non-verbally admit 

that “Oh, I am caught.” The improper fraternization is, 

then, usually curtailed in the future. Your nonjudgmental 

verbal recognition and the perpetrator’s response 

(verbal or non-verbal) to the nurse administrator/ 

leader’s recognized fraternization will often refocus the 

perpetrator’s attention back to their expected nursing 

assignment. 

CURTAILING FRATERNIZATION THROUGH 

VERBAL COMMUNICATION—COGNITIVE 

ENGAGEMENT 

Asking questions as a nurse administrator/leader 

is a thoughtful process. No more “off the cuff” 

conversations! Choose your communication wisely! 

Encourage verbal assessment and evaluation of healthcare 

situations to keep nurses on-track. Cognitive 

stimulation can help replace fraternization behaviors 

and encourage the elevation of nursing cognition. Use 

open-ended questions to stimulate intellectual thought 

and conversation rather than close-ended questions. 

Open-ended questions related to a specific job might 

include: (Cannot be answered by “Yes” or “No.”) 

1. Sally, tell me how that procedure is helping Mr. 

Dobbs. (or) 

2. How is working closely with nurse Jones helping 

you understand the computer charting? 

Closed-ended questions (examples) related to a 

specific job might be: (Requires an answer of “Yes” or 

“No.”) 

1. Sally, is that procedure helping Mr. Dobbs? (or) 

2. Is working closely with nurse Jones helping you 

to understand the computer charting better? 

Always calculate your words and behavior wisely— 

be an example of non-fraternization. You, as a 

nurse administrator/leader, are to be an example of 

correctness in all nursing situations. Your restraint and 

professionalism are why you have nursing leadership 

responsibility. Know WHY you do what you do---don’t 

just DO! Welcome to the covert behaviors of leadership!! 

Remember, you were (or will be) hired as a nurse 

administrator/leader because you are special. 

Prove it! That most often means you know the 

difference between acceptable and unacceptable 

nurse administrator/leadership behaviors. You know 

fraternization when you see and experience it! The 

nurse administrator/leader is the procurer of nonfraternizing 

work behaviors. 

TRUE LEADERSHIP POWER COMES IN THE 

SECRET ABILITY TO RECOGNIZE AND CHANGE 

UNNECESSARY JOB FRATERNIZATION INTO 

PRODUCTIVE JOB-RELATED BEHAVIORS.


Sylvia J. Galloway, RN 

Reprinted with permission from 

Arizona Nurse May 2020 

The population of hospitalized patients aged 65 years 

and older often experience less than optimal outcomes 

as a result of inadequate nutrition. A significant number 

of patients are not sitting in chairs for meals, which leads 

to impaired digestion and malnutrition. The purpose of 

this quality improvement project was to educate patients 

and staff on the benefits and detriments of position during 

mealtime. A literature search was conducted, with few 

articles being found. As a result of this search, a deduction 

was made that the lack of literature proves more attention 

needs to be given to this matter. Patients and hospital 

staff were involved in order to focus on awareness and 

education within the hospital setting. Patients were 

encouraged to be proactive in their care and recovery. 

To determine the impact this has on nutritional intake, a 

select group of mealtime percentages at a rural hospital 

in the southwest was recorded and analyzed, utilizing 

a qualitative review of chart audits. Results served to 

provide awareness of the importance of the relationship 

between nutrition and position. The significance of this 

project included better patient outcomes, less need for 

skilled nursing facilities upon discharge, fewer hospital 

readmissions, and improved patient satisfaction. 

Rationale 

The intent of this quality improvement project was to 

improve nutritional intake. Two key factors contribute to 

patient recovery and rehabilitation: nutrition and functional 

mobility (Resnick & Gershowitz, 2013). The problem of 

patients becoming malnourished while in the hospital has 

been identified. The project included education for patients 

and staff in order to work collaboratively to encourage 

patients to sit in chairs for meals. Proper position facilitates 

eating and increases the percentage of meal consumed. 

As a result, patients experienced better outcomes. 

Evidence 

Nutritional status directly influences factors that 

contribute to functional disability (Cederholm et al., 

2014). Functional disability may lead to malnourishment 

(Cederholm et al., 2014). Loss of lean body mass 

accelerates during bed-rest, putting the hospitalized 

patient at risk for malnutrition (Tappenden et al., 2013). 

Muscle strength decreases by five percent a day when 

hospitalized patients are inactive (Resnick & Gershowitz, 

2013). Patients are more likely to need skilled nursing 

facility placement after discharge when they are not 

properly nourished or assisted out of bed (PBS, 2016). 

Addressing the problem of hospital malnutrition has the 

potential to improve clinical outcomes and quality of care, 

at the same time reducing costs (Tappenden et al., 2013). 

Internal data within the rural hospital in the southwest for 

linking nutrition to patient position was unavailable. 

Patient Position and Nutrition 

PDSA Framework 

Plan 

• Design and facilitate an educational program at a rural 

hospital in the southwest that educates patients and 

staff on the importance of getting hospitalized patients 

aged 65 years and older out of bed for meals when 

diagnosis, condition, and willingness permits. 

• This will produce statistical evidence that patients sitting 

in chairs for meals will experience greater percentages 

of nutritional intake. 

Steps to execute 

• Surveys will be distributed to nursing staff at a rural 

hospital in the southwest to determine reasons patients 

are not getting out of bed for meals. 

• Information gained from the survey will be used to 

improve modifiable barriers. 

• Educational material for staff will be distributed at staff 

meetings and at shift huddles. 

• Laminated cards educating the patient as to the 

importance of getting out of bed for meals will be 

included as part of the patient information packet in each 

hospital room. Nursing will review the cards with patients. 

Do 

• Reflective chart audits will compare percentages of 

meals consumed at breakfast, when most patients are 

in bed and at lunch when most patients are in chairs. 

• Chart audits will occur over a period of one week 

• Key participants will make observations and identify 

barriers to getting patients out of bed for meals to 

determine if the plan should be modified. 

Study 

• Results of the chart audits will be analyzed to 

determine if meal consumption increases or does not 

increase when patients are assisted to chairs for meals. 

• Meal percentages will be compared to the goal of a 

25% increase in meal consumption per meal when 

sitting in a chair. 

• Results will be recorded and a determination made as 

to what was learned and whether the goal was met. 

Act 

• After a study of the results, a conclusion will be made 

as to whether the project was a success and if it did 

not work, what can be modified to improve the results. 

• At this time, a decision will be made to determine 

whether the plan is beneficial and should be expanded 

throughout the hospital inpatient units at a rural hospital 

in the southwest. 

Goals 

• By the conclusion of this project, 50% of the selected 

hospitalized patients aged 65 years and older at a 

rural hospital in the southwest whose diagnosis and 

condition permits will be assisted into a chair for meals. 

• By the conclusion of this project, the selected 

hospitalized patients aged 65 years and older at a 

rural hospital in the southwest whose diagnosis and 

condition permits will increase their nutritional intake 

percentage by 25% per meal over the course of one 

week, evidenced by data collection analysis. 

Conclusion 

The plan included meeting with stakeholders and 

addressing possible barriers. Education materials were 

designed including laminated cards in patient rooms, 

which identified the benefits of spending less time in 

bed. Interdisciplinary team members worked together 

to ensure that selected patients were assisted out of 

bed for lunch. Breakfast was utilized as a comparison 

variable. The focus was to compare meal percentages 

eaten in bed and in chairs. The expectation was that meal 

percentages of patients who are sitting in chairs for meals 

would increase. Percentages were collected and analyzed 

with the assistance of the dietary department. With the 

implementation of this project, success was determined 

based on an increase of patients sitting in chairs for meals 

and subsequent increase in nutritional intake. 

References available upon request 

Sylvia J. Galloway, MSN, RN 

Montana Healthcare Mutual Aid System (MHMAS) is the Emergency 

System for the Advance Registration of Volunteer Health Professionals for 

the state of Montana. MHMAS is a secure, web-based online registration 

system used to register, verify, and credential volunteer health care 

professionals before a major disaster or public health emergency occurs. 

MHMAS is a secure, web-based online registration system used to 

register all levels of medical professionals to be needed to respond to 

a medical and/or public health emergency. 

PICO 

In selected hospitalized patients aged 65 and older 

at a rural hospital in the southwest whose diagnosis and 

condition permits, (P) how does sitting upright in a chair 

for meals (I) compared to lying or sitting in a bed for meals 

(C) affect the percentage of meals consumed (O) within a 

period of one week (T)? 

Problem Statement 

A significant number of hospitalized patients aged 65 

years and older are not sitting in chairs for meals. As a 

result, there is a decrease in meal consumption, leading 

to malnutrition, ineffective digestion, decreased functional 

mobility and an increase in hospital readmissions. 

Once you register you are under no obligation to respond to a request, 

you decide when and where you would like to respond. MHMAS does 

ask for personal information (e.g., SSN, DOB) this is needed so we 

can conduct a background check once a request is made for medical 

professionals. 

If you would like to register, please follow the link below. 

Register Here @ https://mhmas.org/ 

Significance to Nursing 

Nursing is responsible for ensuring safety and providing 

care to patients. One element influencing health outcomes 

is nutritional status. Hospitalized patients generally eat 

less than 50 percent of their meals (Robert, Chaboyer, 

& Desbrow, 2015). Nutritional status is correlated with 

intake, which is directly under the control of nurses and 

interdisciplinary team members including subordinate staff. 

Positioning is one element that affects intake. Nursing 

can impact health outcomes by optimizing mealtime 

positioning. A significant number of hospitalized patients, 

whose diagnosis and condition permits, are not sitting 

in chairs for meals. When permitted, the most beneficial 

position for eating is in an upright, sitting position.


Parent Resources 

Summary Tips for 11-14-year-old 

• Homework: https://parentingmontana.org/wp-content/uploads/2019/01/ 

Homework-Ages-11-14-Summary.pdf 

• Routines: https://parentingmontana.org/wp-content/uploads/2019/01/ 

Routines-Ages-11-14-Summary-.pdf 

• Discipline: https://parentingmontana.org/wp-content/uploads/2019/01/ 

Discipline-Ages-11-14-Summary.pdf 

• Chores: https://parentingmontana.org/wp-content/uploads/2019/01/Chores- 

Ages-11-14-Summary.pdf 

• Stress: https://parentingmontana.org/wp-content/uploads/2019/01/Stress- 


Linda Krantz 

Chronic Disease Prevention 

& Health Promotion Bureau 

406.444.4105 

ParentingMontana.org provides easy-to-use parenting tools to support your 

child’s success from kindergarten through the teen years. ParentingMontana. 

org includes information on parent resources, specific topics by each age 

group, and I want to know more topics. Here are some quick summary pages 

for parents, or those in a parenting role, that may be facing challenges during 

this crisis. 

Summary Tips for 5-10-year old 







• Chores: https://parentingmontana.org/wp-content/uploads/2019/01/ 

Chores-Ages-5-10-Summary.pdf 

• Stress: https://parentingmontana.org/wp-content/uploads/2019/01/ 

Stress-Ages-5-10-Summary.pdf 

• Meltdowns: https://parentingmontana.org/wp-content/uploads/2019/01/ 

Meltdowns-Ages-5-10-Summary.pdf 

Summary Tips for 15-19-year-old 







• Chores: https://parentingmontana.org/wp-content/uploads/2019/01/Chores- 


• Stress: https://parentingmontana.org/wp-content/uploads/2019/01/Stress- 


Car Seat Safety 

Motor vehicle crashes are the leading cause of death for Montana children. The 

best way to keep children safe in the car is to use the right seat, the right way. In 

fact, a correctly used and installed car seat can reduce the risk of injury in a car 

crash by 71 to 82 percent. But four out of five car seats are incorrectly used or 

installed. We know car seats can be complicated and parents and caregivers are 

often doing their best to keep children injury-free. 

To help ensure children are riding safely, Montana has car seat fitting stations 

and child passenger safety programs located across the state where certified Child 

Passenger Safety Technicians teach parents and caregivers how to install and use 

their car seat correctly. Child Passenger Safety Technicians equip parents and 

caregivers with a working knowledge of their car seat so that they feel empowered 

to make safe choices for their child and confident that they know how to use and 

install their car seat correctly every time. 

Families should be encouraged to have their car seat inspected by a Child 

Passenger Safety Technician as they grow and transition into different types of 

car seats. This is a practice that can be reinforced during well child checks. You 

can find a fitting station near you at NHTSA.gov/equipment/car-seats-and-boosterseats. 

If you are working with a family in need of a car seat, contact your local health 

department or Erin Root at Montana Department of Transportation at eroot@mt.gov 

to learn more about resources in your area. You can also find electronic and printready 

safety materials to support your work with families at trafficsafetymarketing. 

gov, or by contacting Erin Root.


MEMBERSHIP 

MATTERS! 

Montana Nurses Association would like to 

invite you to join us today! 

BENEFITS INCLUDE: 

• EMPOWERING RNs TO USE THEIR VOICES 

IN THE WORKPLACE 

• IMPROVING PATIENT CARE 

• HAVING INPUT REGARDING WAGES & 

BENEFITS 

• CONTINUING EDUCATION OPPORTUNITIES 

• LEGISLATIVE REPRESENTATION 

Call or email today 

jill@mtnurses.org 

(406) 442-6710 

Applications also available on 

our website. 

mtnurses.org 

Has your contact information 

changed? 

New name? New address? 

New phone number? 

New email address? 

To update your contact information, please email or call 

Montana Nurses Association: 

jill@mtnurses.org or 406-442-6710

Everyone Deserves A Job They Love!! 

Let Us Help Today, 

Call 406.228.9541 

Prairie Travelers is recruiting Traveling 

Healthcare Staff in Montana, 

North & South Dakota 

• Registered Nurses (Hospital, ER, ICU, OB and LTC) 

• Licensed Practical Nurses 

• Certified Medication Aides 

• Certified Nurse Aides 

• Full-Time and Part-Time 

Prairie Traveler’s Commitment 

to our Staff 

• Excellent Wages • Health Care Benefits 

• Travel Reimbursement • Annual Bonus 

• Paid Lodging 

• Zero Assignment 

• Flexible Work Schedules Cancellations 

• 24/7 Staff Support • Varied Work Settings 

APPLY TODAY 406.228.9541 

Prairie Travelers Recruitment Department 

130 3rd Street South, Suite 2 • Glasgow, MT 59230 

For an application or more information, visit 

www.prairietravelers.com 

Thrive where you live. Grow your career—while hiking, skiing, fishing and living the good life in Montana. The 

Great Falls Clinic is a progressive, physician-led healthcare organizations—and we think living a good life is just 

as important as building a career. Our comprehensive care facilities are headquartered in and around Great 

Falls, Montana—an exceptionally safe, affordable town surrounded by three mountain ranges. 

The Great Falls Clinic Hospital is seeking experienced Utilization Review, Critical Care, PACU, Cath Lab & OR Circulating Registered Nurses for our 

growing service lines. 

• 12 hour shifts; with call rotation 

• Competitive salary and benefits 

• Vacation/sick leave package that promotes health-work life balance 

• Retention and moving bonus 

If you’d like to balance working in a busy, forward-thinking organization while playing in a recreational paradise, 

contact Joey Richman at 406-454-7325 or joey.richman@gfclinic.com. 

Great Falls Clinic Hospital | 3010 15th Ave South Great Falls MT 59405 | www.gfclinic.com

Montana Pulse - November 2020

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