Alabama Nurse - November 2020

alabamanurses.org
A publication of
The Alabama State
Nurses Association
November, December 2020, January, 2021 • Volume 47 • Issue 4
Inside
Award Winners. .................................. 11
Convention Highlights. .......................... 12-14
ED's Notes. ......................................3
Legal Corner. .....................................4
Meet Your ASNA Board..............................6
Membership Corner .............................. 8-9
Resolution. ......................................10
BROUGHT TO YOU BY:
A quarterly publication distributed to more than 72,000 RNs and LPNs in Alabama
CONGRATULATIONS
to Dr. Lindsey Harris, DNP,
FNP-BC as the New President
of the Alabama State Nurses
Association
At its virtual House of Delegates, on September
25, 2020, the Alabama State Nurses Association
(ASNA) passed the gavel to Lindsey Harris, DNP,
FNP-BC to be the organization’s new president. Dr.
Harris was elected “President-elect two years ago
and under ASNA Bylaws, has now ascended to the
office of President. ASNA is proud of Dr. Harris’
commitment and service as President-elect and looks
forward to her vision and leadership as President. It
is also praiseworthy to announce that she is the first
person of color to hold the position of President since
ASNA formed 107 year ago.
“This is truly an honor and I am thankful for
the opportunity to serve,” said Harris. “It is very
important to be a part of a professional organization
in your field. ASNA represents all nurses in the state
of Alabama. I wanted to be a part the organization of
change, one that influenced policy and gives back to
the community.”
After graduating from Samford University with
a Bachelor of Science in nursing and a minor in
business, Dr. Harris began her nursing career at the
University of Alabama at Birmingham Hospital. She
had the opportunity to work in the RN internship
program as a staff nurse where she gained a great
deal of experience as she worked in various parts of
the hospital, including women’s health, psychiatry,
and general medicine.
Harris completed her Master of Science in
Nursing at the University of Alabama at Birmingham
with a concentration in family practice. She also
completed the Doctor of Nursing Practice program at
the University of Alabama at Birmingham in 2016.
Harris is currently working as an Inpatient glycemic
control nurse practitioner on the inpatient glycemic
management team within the University of Alabama
at Birmingham Hospital.
“Nurses are the
largest workforce
in healthcare and
the ‘Most Trusted
Profession’ as noted
by Gallup Polls for the
past 18 years in a row,”
explained Harris.
“As professionals,
nurses should be at
the policy discussion
table. ASNA gives
nurses that voice and
I am proud to serve
with them in an organization that truly makes a
difference!”
ASNA is affiliated with the American Nurses
Association and Dr. Harris has served as a Delegate
at the ANA Membership Assembly in Washington,
DC for the past two years. She will continue as an
ANA Delegate in her role as ASNA President.
Dr. Harris wants to see more nurses realize
the importance of membership and active
participation, when possible, in the Alabama State
Nurses Association. Harris said, “Young – early
career nurses can ESPECIALLY benefit from the
relationships, mentorships and the cutting-edge
alerts/updates provided by ASNA/ANA. Peers and
supervisors are impressed when they see that a coworker
has “inside-track/early warning” info due
to their membership in ASNA/ANA.” Dr. Harris is
an innovative nurse leader and wants to see nurses
engaged and aware of issues that impact their careers
and the quality of nursing practice. ASNA hopes that
nurses across the state will support her vision and
JOIN ASNA/ANA. She knows that “Together…we
are Stronger!”
Sign up to receive Alabama Nurse as a digital copy
every quarter! Visit https://tinyurl.com/ALNurse
Elizabeth Morris Annual
Clinical Sessions – FACES ’21
Save the Date
Tuesday, April 20, 2021
current resident or
Non-Profit Org.
U.S. Postage Paid
Princeton, MN
Permit No. 14
ANA's Membership Assembly
Re-Elects Ernest Grant as
National President
Ernest J. Grant, PhD,
RN, FAAN, has been reelected
to a second term
as the American Nurses
Association’s (ANA) national
President. The voting
representatives of ANA's
Membership Assembly also
elected four members to the
9-member board of directors.
Terms of service will begin
January 1, 2021.
“It is with great pride, duty and purpose that
I serve nurses, represent nurses, and advocate
on behalf of nurses nationwide,” said Dr. Grant.
“Throughout history, nurses have responded to every
public health crisis, marched for civil rights and
provided patients and communities optimal care. As
our nation grapples with the COVID-19 pandemic,
racism and health inequities, nurses are ANA's
Membership Assembly Re-Elects Ernest Grant as
National President once again demonstrating the
resolve, compassion and undisputed skill that defines
our distinguished profession. Undoubtedly, the “Year
of the Nurse” looks much different than we had
expected. We have experienced tremendous loss, but
we are resilient, and we will emerge even stronger.
I am forever proud to be a nurse and to serve our
profession in the company of other great leaders.”
These ANA members were elected to serve on
the board of directors: Director-At-Large Brienne
Sandow, MSN, RN, NEA-BC, of the Idaho Nurses
Association; Director-At-Large, Staff Nurse Amanda
Buechel, BSN, RN, CCRN, of ANA-Illinois.
Ernest Grant President continued on page 3

Page 2 • Alabama Nurse November, December 2020, January 2021
HOT JOBS!
The Alabama State Nurses Association is proud
to announce a fresh UNIQUE opportunity for job
seekers and employers. Our new Career Center, HOT
JOBS marries two services that have great benefits
for job seekers and employers. The HOT JOBS site,
alabamanurses.org/hotjobs, helps the prospective employee
(nurse) enhance their chances in the application / interview
process with FREE consultation from ASNA’s professional
career coach, Bridget Stevens. Bridget has over 25 years
experience as a recruiter in the medical field and is widely
respected by major employers in the state. You can ask for
her help at the email provided below.
Employers will love using HOT JOBS to prioritize
high demand positions in their posts. Bridget can help
employers get set up on HOT JOBS and refer qualified
candidates with no recruiting fee! If you are a job seeker
or HR staff, give Bridget a call or email and find out how
ASNA’s HOT JOBS can help you.
Alabama
nurse
ASNA Board of Directors
President Lindsey Harris, DNP, FNP-BC
President-elect James Hardin, MSc, BSN, RN
Vice President Frederick Richardson, BSN, RN
Secretary Julie Jones, EdD, MSN, RN
Treasurer Frankie Wallis, DNP, NEA-BC, COI
District 1 Kim Driggers, MSN, FNP-C
District 2 Jennifer Humphries, DNP, CRNP, NNP-BC
District 3 Adrienne Curry, DNP, RN
District 4 Brenda Woodmansee, DNP, RN
District 5 Katilya Ware, PhD, RN
ASNA would like to extend our deepest
sympathies to the following:
Ms. Jean Gouge, longtime ASNA District 5 Member on
the passing of her husband Jim.
Travis Parker, ASNA Webmaster on the passing of his
mother.
The family of Supora Sparks Thomas,
MBA, FAAN, BSN, RN
The family of Barbara Williams Walker, BSN, RN
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
Author Submission Guidelines
for Alabama Nurse
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advertisement, please contact our publisher, Arthur
L. Davis Publishing Agency, Inc. at sales@ALDpub.
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Commission on Professional Issues: Jay Prosser, MSN,
CCRN, NE-BC
Parlimentarian: TBD
Recent Grad Liaison: Kristina Gentle, RN
ASNA Staff
Executive Director, Dr. John C. Ziegler, MA, D. MIN
Director of Leadership Services,
Charlene Roberson, MEd, NPD-BC, RN-BC
ASNA Attorney, Jon Barganier, Sr., JD
Programs & Structural Unit Coordinator,
April Bishop, MPA, BS, ASIT
Continuing Education Coordinator,
Virginia (Ginger) Collum, MSN, RN
Our Mission
ASNA is committed to promoting excellence in nursing.
Our Vision
ASNA is the professional voice of all registered nurses
in Alabama.
Our Values
• Modeling professional nursing practices to other
nurses
• Adhering to the Code of Ethics for Nurses
• Becoming more recognizably influential as an
association
• Unifying nurses
• Advocating for nurses
• Promoting cultural diversity
• Promoting health parity
• Advancing professional competence
• Promoting the ethical care and the human dignity of
every person
• Maintaining integrity in all nursing careers
Advertising
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. ASNA 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 Alabama State 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. ASNA 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 ASNA or
those of the national or local associations.
The Alabama Nurse is published quarterly every February,
May, August and November for the Alabama State Nurses
Association, 360 North Hull Street, Montgomery, AL 36104
© Copyright by the Alabama State Nurses Association.
Alabama State Nurses Association is a constituent
member of the American Nurses Association.

November, December 2020, January 2021 Alabama Nurse • Page 3
John C. Ziegler
MA. D. MIN,
ASNA Executive Director
The Star Wars character,
YODA, was a JEDI of few
words. In spite of his reverse
grammar/syntax manner of
speaking, his wisdom was
profound and straight to the
point. If YODA spoke to nurses,
I think he would say: “BUSY LIVES YOU NURSES
HAVE! TIME HAVE YOU NOT!” I’m no YODA…but
I do have something vital to tell you and I will attempt
to be wise and to the point – because – “time have
you not!” I am saddened to report that, regarding
COVID-19 federal and state policy, nurses have
largely been ignored by our public officials and
policy makers. Nurses have been publicly praised by
almost everyone during the pandemic and our voices
have been heard…but not heeded. If that does not
make you curiously troubled…then “WOKE, YOU ARE
NOT!” Let me explain.
This general lack of response is not a failure of
your professional organizations. We could use pages
to list the efforts of your fellow nurses and staff
at the Alabama State Nurses Association and the
American Nurses Association to take your “boots on
the ground” experiences and professional advice to
the HIGHEST levels of local, state and federal policy
makers. You/we have been heard…repeatedly, about
what was needed to protect healthcare workers and
patients. Although you have busy lives and “time
have you not” your membership in ASNA/ANA has
given you representation at the table and a voice!
Your membership matters and numbers matter. Your
professional expertise and the public confidence in
nurses as “The Most Trusted Professionals” for 18
straight years (Gallup Polls) matters. Why then were
you HEARD…BUT NOT HEEDED by politicians on
both sides of the aisle and policy makers in corporate
board rooms?
Throughout the spring, summer and fall ASNA
advocated for nurses of ALL specialties regarding
COVID-19 and ongoing issues affecting nursing
practice. We were “at the table” in meetings,
conversations and on personal calls with Alabama
Congresspersons, Senators and the Governor’s Office.
ANA President, Dr. Ernest Grant and ANA Chief
Nursing Officer were at the White House with a small
group of advisers in the spring. Your ASNA President
was with a small group of experts at the table with
Governor Ivey, State Health Officer, Dr. Harris and top
federal COVID officials. As ASNA Executive Director,
I was extensively engaged with the Governor’s Office,
State Legislators, Public Health officials, CNO’s
and College of Nursing Deans / Directors regarding
COVID issues. Again, I want to reiterate – locally
and nationally we were engaged with officials of both
parties and leaders in the private sector as well. You
may ask; “What ISSUES brought forth by nurses
were HEARD BUT NOT HEEDED?” And; Why were
Ernest Grant President
continued from page 1
The following ANA board members were re-elected:
Secretary Stephanie Pierce, PhD, MN, RN, CNE, of the
Louisiana State Nurses Association; Director-At-Large
Jennifer Gil, BSN, RN, of the New Jersey State Nurses
Association.
Those continuing their terms on the ANA board in
2021 are: Vice President Susan Y. Swart, EdD, MS,
RN, CAE of ANA-Illinois; Treasurer Jennifer Mensik
Kennedy, PhD, MBA, RN, NEA-BC, FAAN of the Oregon
Nurses Association; Director-at-Large Jeff Watson, DNP,
RN, NEA-BC, of the Texas Nurses Association; DirectoratLarge,
Recent Graduate Marcus Henderson, MSN, BSN,
RN of the of the Pennsylvania State Nurses Association.
Elected to serve on the Nominations and Elections
Committee are: Amanda Foster, BSN, RN, of the Arizona
Nurses Association; Tonisha Melvin, DNP, CRRN, NP-C,
of the Georgia Nurses Association; Marylee Pakieser,
MSN. RN. FNP-BC, of ANA-Michigan.
ED’s Notes
Straight Talk to Nurses
nurses, the largest workforce in healthcare…the most
trusted professionals… “HEARD” but not “HEEDED?”
WHAT ISSUES WERE HEARD: Here are but a few
of your ISSUES.
1. Nurse surveys conducted by ASNA and ANA
confirmed that during the spring and summer,
PPE supply chains and demands placed upon staff
to wear, wash and reuse unsafe PPE was horrible.
2. Thousands of nurses experienced unit closures
and layoffs with little or no assurances of their
employment and financial future. While federal
programs provided funding for small businesses
and employees – many nurses found themselves in
“no man’s land” regarding specifics in the relief
packages. We had reports of nurses being spurned
at unemployment offices by staff who rudely said
things like; “Ha! Nurses can get a job anywhere…
we don’t consider nurses as qualifying for
unemployment benefits.”
3. Senior nursing students scheduled to graduate
in May or August were told that the jobs they
thought they had, were put on hold due to “hiring
freezes.” Sites that gave NCLEX exams closed
and when reopened had long waiting lists. Many
Alabama new grads had to go to other states to
take the NCLEX!
4. Alabama received over $1 billion 800 million
federal dollars for COVID relieve grants. ASNA
applied for 3 CARES ACT grants based on
YOUR EXPRESSED NEEDS in our surveys
and communications networks. The Hospital
Association got $50 million. No foundation or
charity – including churches, the Red Cross, or
the Alabama Nurses Foundation was allowed to
apply for more than $15 thousand…the ceiling
for 501-c-3 Non-Profits. Yet, the Alabama
Nursing Home Foundation received $50 million.
The news reported the Alabama Nursing Home
“Association” got the 50…but the paperwork from
the State Finance Office – sent the money to their
Foundation! After months of work – ASNA and
nurses received $0!
These are but a few of the issues that were heard…
but not heeded. The reports from nurses and healthcare
workers in our Long-term Care survey were extremely
disturbing. Thousands of LTC employees in Alabama
were infected with COVID-19.
WHY NOT HEEDED?
So, why were your voices heard but not heeded?
1. Political Power. Many times, I have been told
these EXACT WORDS by elected officials…
“If the nurses would ever get together…they
could get anything they want!” That’s a pretty
broad statement – but the point is clear. Most
nurses are focused on their patients, their careers
and their families. Policy and politics is one of
those overwhelming issues where “Time Have
You Not!” (Yoda) And with the numerous nurse
specialty organizations out there now…many
nurses feel that being a member of their specialty
org is enough. Why join a big “umbrella” org like
ASNA or ANA when I get CE’s and updates from
my specialty org? Good point.
2. Fragmentation. Ever seen one of those nature
shows on TV where predators like wolves or lions
work to separate a target from the protection
of the herd? The “herd” in our profession for
over 107 years has been the Alabama State
Nurses Association and the American Nurses
Association. By isolating ourselves (nurses) into
silos of specialty organizations we have lost the
collective power of the profession! There are
over 100,000 licensed nurses in Alabama. This is
STRAIGHT TALK TO YOU AS A NURSE. Until
you see the benefit of your participation (actively
or passively) as a member of both your specialty
org and ASNA/ANA – nursing practice will be
controlled by the powerful. Yes, your voices can
and may be heard. No, they will NOT be heeded.
This has been true for many years. Yet COVID-19
has shined the light on the URGENCY and the
NECESSITY for nurses to come together and have
large numbers represented at the table. ASNA is
the only nursing organization in Alabama that
has a building, a staff, two full-time lobbyists
and the mission to promote excellence in nursing
and protect the interests of nurses of ALL
specialties. You matter. Even if “Time have you
not” your membership in ASNA/ANA matters.
Joint membership state and national is only $15 a
month. Good grannies! Go to alabamanurses.org/
join RIGHT NOW with a click – and help nursing
be heard AND heeded!
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“This publication is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services
(HHS) as part of an award totaling approximately $1.1 million with zero percentage financed with nongovernmental sources. The contents are those
of the author(s) and do not necessarily represent the official views of, nor an endorsement, by HRSA, HHS or the U.S. Government.”

Page 4 • Alabama Nurse November, December 2020, January 2021
Jon D. Barganier
J.D.
Let me make a disclosure
right out of the chute, I worked
for a pharmaceutical company
for twenty plus years and in
the pharmaceutical industry
in general for most of my
professional life, about forty
years. I am biased toward that
industry like I am biased toward nursing because I
believe both have improved and/or prolonged the lives
of millions of people during the past century. Penicillin
and countless other antibiotics, insulin, oncology
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Legal Corner
The Debate on Drug Costs
drugs, mental health drugs, HIV drugs, vaccines, and
presently the therapeutics coming to the aid of health
care practitioners fighting Covid 19, and ultimately a
vaccine for Covid 19 and in the future a vaccine for all
coronaviruses that may well stave off future pandemics,
all have created a health care environment that makes
us hopeful where in previous centuries doom reigned.
The pharmaceutical industry has made a massive
impact on our well being today. HIV was once a death
sentence but is now manageable. The only answer to
severe mental illness was warehousing those suffering
with the disease but today, thanks to new treatments,
many can live in their homes or communities. Former
Alabama Mental Health Commissioner Kathy Sawyer
credited new medicines with her ability to close or
reduce mental health hospitals in the state. Those are
just a few examples of how the pharmaceutical industry
has brought progress to the treatment of illnesses once
untreatable and the industry is still pushing forward to
reach goals that are within its grasp. The pandemic in
which we find ourselves today has tested the limits of
what that industry can do working with government to
find new pathways for drug advances in record time.
As nurses, I’m sure you recognize the advances of drug
therapy even more than me because you work where the
rubber meets the road.
But, that industry faces challenges, perhaps
better viewed as existential threats. Some look at
the pharmaceutical industry and are reminded of the
comic strip, Pogo, and its famous admonition, “we
have met the enemy and he is us.” The soaring price of
pharmaceuticals through the years has focused policy
makers on the industry with the intent of stanching
the hemorrhage of high costs. They claim the industry
is price gouging. The industry counters that there are
other explanations for rising costs. Plaintiff attorneys
have smelled the blood in the water and pursued drug
companies with thousands upon thousands of lawsuits
each year against drugs claiming they have harmed
patients more than helped them. Lawsuits, the industry
claims, is a cost of doing business and results in higher
prices. The pharmaceutical industry also points to
government oversight that requires years of costly and
time-consuming trials and patents that cut into the
time that a drug is profitable before it “goes generic”
and loses its profitability. The industry also points to
the number of failed drugs that it funds with billions
of dollars before they prove ineffective or unsafe. The
drugs that make it through the gauntlet of clinical trials
and become profitable pay for all those failed drugs
that cost hundreds of millions of dollars to test but
never get to the marketplace. Another culprit in the
high costs of drugs are the “middle men” that drive
the costs higher. These are insurance companies or
pharmacy benefit managers that require pharmaceutical
manufacturers to pay discounts or rebates to them as a
prerequisite to their drugs being placed on formularies
or in the alternative, restricted.
I began this article admitting to a bias that I have
that favors the arguments of pharmaceutical companies
in the drug price debate but I would also admit that
profitability is very important to the pharmaceutical
industry. As I said before, profitability funds innovative
new drugs but it also pays for its failures along the way.
Still, profit is a motive and results in the higher cost of
drugs.
So why is this debate important to nurses?
Because, you are where the rubber meets the road.
You understand the role that drugs play in health
care. You are an influencer on health care policy. For
those reasons, it is good to know the parameters of the
debate. I hope that my remarks in this column have
helped define them for you, however biased they may
be.

November, December 2020, January 2021 Alabama Nurse • Page 5
Elizabeth Morris Annual
Clinical Sessions – FACES ’21
Call for Abstracts
Oral and Poster Presentations
Tuesday, April 20, 2021 | Montgomery, Alabama
Requested Topics
• Issues reflecting the future of Nursing
• Innovations in Nursing Care
• National or Global Issues/Initiatives
• Research
Abstract only accepted online at www.alabamanurses.org
Presentation Requirements
• Poster presentations are accepted for easel ONLY
• Abstracts must be completed online
• Individuals accepted for presentation are expected to register for conference
at a reduced rate
• At least one Poster presenter must be present/registered to present
Deadline for Submission: January 15, 2021
NOTE: Depending on the global pandemic situation, presentations may either
be in person or virtual

Page 6 • Alabama Nurse November, December 2020, January 2021

Page 8 • Alabama Nurse November, December 2020, January 2021
Membership Corner
New/Renew/Rejoining ASNA Members (July 16 – September 15, 2020)
District 1
Marsha Adams
Amanda Anderson
Joseph Andrews
Nayeli Aviles Hernandez
Nichola Baker
Jessica Baughman
Betty Beck
Kelly Berrong
Ann Bianchi
Nesha Bittler
Linore Bouska
Alicia Bridgeforth
Theresa Calhoun
Chenny Cargile
Samantha Carroll
Misty Coats
Susan Copeland
Mia Crutchrandolph
Lynn Curry
Marjorie Dollar
Melissa Florence
Sarah Fontaine
Wendy Gannon
Denise Garrison
Meaghan Hampton
Elizabeth Harper
Farrar Hickey
Deborah Hoenig
Elizabeth Holcomb
Lauren Holland
Martha Holt
Stacy Humphress
Carl Ivey
Brooke Jones
Rosita Karigan
Emily Lambert
Sarah Logan
George Lucas
Deborah Lukens
Kristine Massey
Kim McCaleb
Kathleen McCoy
Amanda Medders
Danie'L Mills
Thomas Moore
Susan Morgan
Katherine Murray
Pamela Nelson
Tracy Norton
Louise Okeefe
Kimberly Rachford
Cynthia Raines
Joan Reed
Antris Scales
Elizabeth Scrivens
Katherine Sherrouse
Cathy Simpson
Alicia Sims
Tori Smith
Rachel Speakman
Patricia Stults
Samantha Sullivan
Kindra Swauger
Donna Sykes
Desiree Washburn
Laura Williams
Hildegarde Wilson
District 2
Patricia Adams
Karen Barnette
Michael Callihan
Caitlin Campbell
Sonja Curtis
Jeri Dunkin
Charles Gills
Rodney Henson
Katherine Hicks
Darlene Holley-Jones
Scott Hunter
Xylina Jackson
Mary Kelley
Kelsey Morton
Barbara Odom
Linda Olivet
Tracy Parady
Robin Parnell
Tomeka Royster
Lisa Ryan
District 3
Dekozlymn Anderson
Mudasir Andrabi
Susan Appel
Michael Appling
Whitney Bailey
Marie Bakitas
Jody Bishop
Victoria Bolus
Pamela Bowen
Mary Brandler
Abbie Brewster
Sylvia Britt
Tammy Brown
Shirley Burl
Rocky Caldwell
Jordan Carter
Pamela Chandler-Edwards
Patricia Cleveland
Angela Cox
Rachel Davidson
Jane Davis
Andria Diamond
Anna Diegmann
Kimberly Dowdell
Lisa Duke
Megan Early
Ryan Ernst
Nikesha Fantroy
Hunter Franklin
Ketha Franklin
Alesia Gilmer
James Gramling
Karen Handley
Charman Harper
Tamika Harris
Alison Hayes
Lori Hicks-Glazner
Lindsey Howell
Sheena Jackson
Carthenia Jefferson
Kaitlyn Jones
Christian Jordan
Vlada Kent
Kelli Kirby
Kathleen Ladner
Jacquelyn Lambert-Davis
Esther Lange
Rebecca Langner
Ellen Lazarre
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Carolyn Pickering
Casey Ramsey
Heather Rankin
Brandi Reedy
Brittany Reynolds
Willamena Richardson
Susan Russell
Carol Rutledge
Cherronica Scovil
Cynthia Selleck
Dongsheng Shi
Allison Shorten
Jennifer Shurette
Marlena Smith
Victoria Smith
Deborah Stewart
Stephanie Suggs
Stephanie Tajer
Alexis Taylor
Jo Anne Turner Anderson
Patricia Waldrop
Judy Washington
Jorge Waters
Sandee Weinstein
Heather Weller
Elaine Whiteside
Kayla Williams
Lola Williams
Anita Williams-Prickett
Victoria Willis
English Wilson
Travestine Wright
Sammy Yassin
Kimberly Young
District 4
Alesha Boykin
Kim Cooper
James Cotten
Krystle Dailey
Paula Gibson
Roslana Gray
Misty Guy
Ruth Harrell
Stephanie Hedden
Jamie Horstman
Cindy Horton
Barbara Johnson
Rachel Klumpp
Heidi Knowles
Ursula Lawrence
Bethany Lee
Curtis Mathis
Sheneka Morris
Melissa Noojin
Gwendolyn Owens
Stacie Reitenger
Shanavia Rivers
Leslie Sharbel
Taunya Simmons
Barbara Melton
Turner Helen
Viles Miranda
Williams
District 5
Charlotte Babington
Kimberly Bartlett
Courtney Berry
David Campbell
Pamela Carver
Allison Chandler
Tiffani Chidume
Natasha Colvin
Rayanne Daniels
Stephanie Daniels
Catherine Davis
Gwenevere Davis
Kelli Davis
Angela Dawkins
Marilyn Denney
LaToya Driskell
Eboni Elmore
Katalin Esther
Sherry Geohagan
Courtney Glover
Robin Gosdin Farrell
Jeannie Handey
Gretchen Hartnell Vercher
Susan Hayden
Toni Herman
Amanda Innes
Tanya Johnson
Zelda Jones
Chrystal Logan
Labrenda Marshall
Robin McCormick
Jan McLendon
Gina Moone
Heather Moreland
Kayla Motley
Yashinaria Nalls
Linsey Park
Lee Patino
Jasmine Pemberton
Vivian Peterson
Sarah Pounds
Kirstan Pyle
Holly Scardina
Janice Seip
Clara Smith
Katelynn Smith
Teresa Stroud
Jennifer Terry
Kayla Theuerkauf
Dorothy Thompson
Sharie Umbarger
Shellye Vardaman
Marguerite White
Shunda Wilburn
Angela Wilkerson
Aimee Williams
Katheryn Williams
Whitnie Willis
Darlene Wilson

November, December 2020, January 2021 Alabama Nurse • Page 9
District 2
We have two Citation
of Excellence Awards
Recipients in our District!
Congratulations to both of
these ladies.
Jessica Dutton, RN has been a
nurse for 14 years. The Neonatal
Intensive Care Unit (NICU)
is where you will witness her
compassion for her patients. She
is an outstanding nurse and a
true advocate for her patients and
families. She is clinically sound
and her colleagues respect her
as a leader. It is not a surprise
that she has been elected for the
Citation of Excellence Award.
Olivia Smith, RN has been
a nurse in the NICU for nearly
three years. She demonstrates
great critical thinking skills at
the bedside and is a team player.
She is a hard worker and shows
true leadership. Olivia is a
member of Project Sweet Peas, an
organization that supports NICU
families in need. Her advocacy is
reflected by her dedication to our
local NICU families by assisting
in projects that help raise awareness and funds in order to
assist families in need.
Congratulations to the following
District 2 Scholarship recipients:
Membership Corner
April Ervin (She is currently
pursuing her Master of Science
in Nursing (MSN) degree with a
focus in nurse education from the
University of North Alabama and
plans to graduate in December
2020. She is currently attending
the Leadership Academy through
ASNA)
Jasmine Rogers (is a senior at
The University of Alabama. Once
she graduates she hopes to pursue
a career as a critical care nurse)
Ariel Rocker (is currently a
nursing student at University
of West Alabama and hopes to
pursue a career in Labor and
Delivery)
Sign up to receive Alabama Nurse
as a digital copy every quarter!
Visit https://tinyurl.com/ALNurse

Page 10 • Alabama Nurse November, December 2020, January 2021
Sign up to receive Alabama Nurse as a
digital copy every quarter!
Visit https://tinyurl.com/ALNurse
Resolution
Support of LTC Health Care Providers
Whereas: Nurses and other health care providers are
precluded from providing comprehensive wrap around care due
to the demands of the prevention of the spread of COVID-19 in
LTC institution; and
Whereas: Residents in LTC institutions are experiencing
declines in health due to lack of stimulation, socialization, and
isolation; and
Whereas: There is a documented lack of PPE in many LTC
institutions thus impacting the health of both providers and
residents; and
Whereas: Nurses, as well as other health care providers, are
experiencing extraordinary stress due to the changed demands
in the workplace; and
Whereas: ASNA has surveyed nurses in Alabama twice and
determined an extraordinary level of stress impacting care; and
Whereas: ASNA also surveyed Alabama LTC health care
providers and determined the following stressors: lack of staff
to provide care, lack of adequate PPE, isolation of residents
resulting in decline of health, time needed for charting diverting
attention away from direct patient care, loss of dignity of
residents due to isolation, generalized fear, frustration in the
ability to communicate with deaf residents when face masks
cover the mouth; be it therefore
Resolved: That ASNA partner with the Alabama Counseling
Association to provide opportunities to seek listening and
counseling services; be it therefore
Resolved: That ASNA communicate with the Alabama
Nursing Home Association to collaborate on initiatives to
support LTC health care providers; be it therefore
Resolved: ASNA distribute information about Emotional
PPE.org which provides free confidential counseling to nurses
and other health care providers in collaboration with the
Alabama Counseling Association; be it therefore
Resolved: ASNA distribute information about Project
Respite which provides free confidential listening to nurses and
other health care providers in collaboration with the Alabama
Counseling Association.
Submitted by Drs. Lindsey Harris, Frankie Wallis, Arlene
Morris, and The Alabama Counseling Association

November, December 2020, January 2021 Alabama Nurse • Page 11
Award Winners
Health Policy Award – Dr. Eileen Meyer
Dr. Eileen Meyer is the current
Assistant Director of Advanced
Practice Providers at the
University of Alabama at
Birmingham Hospital system. In
addition, Dr. Meyer presently
serves as the Vice President for
Policy for the Nurse Practitioner
Alliance of Alabama. In her
roles, Dr. Meyer has worked to
increase the procedures that can
be performed by nurse
practitioners throughout the state. Through her advocacy,
nurse practitioners are working more closely with their full
scope of practice and our state leaders are more informed
to the breadth of the role of the nurse practitioner in
Alabama.
Lillian Holland Harvey Award –
Dr. Valarie Thomas
Dr. Valarie Thomas is a faculty
member at Auburn University
where she leads efforts in
outreach to Ghana and currently
chairs the Auburn University
School of Nursing Diversity and
Inclusion Committee. Through
her work, Dr. Thomas has
developed free healthcare clinics
in West Africa that provide
wellness and healthcare services
to include blood pressure, blood
glucose, urine, ear, and eye screenings. In addition, Dr.
Thomas has promoted advancement for minority groups
and assisted in promoting services for women, students,
and faculty in the Auburn community.
Outstanding Non-Member Award –
LaKeva Harris
Ms. LaKeva Harris is a faculty member at the Anderson
College of Nursing and Health Professions at the
University of North Alabama. Ms. Harris is a certified
family nurse practitioner and was instrumental in opening
the first pediatric urgent care clinic, Kids First Pediatric
Urgent Care, LLC, in the Shoals area. Ms. Harris serves as
role model for senior nursing students and volunteers her
time in the community in the Respite Program to provide
a night of care for children with special needs and their
siblings for local community parents.
Cindajo Overton Outstanding Nurse Educator
Award – Dr. Natalie Baker
Dr. Natalie Baker is an Associate
Professor at the University of
Alabama at Birmingham School
of Nursing where she teaches in
the adult-gerontology primary
care nurse practitioner program.
In 2018, Dr. Baker was
recognized as a Gerontological
Distinguished Educator by the
National Hartford Center of
Gerontological Nursing
Excellence. In addition, Dr. Baker
is a Fellow of the American Association of Nurse
Practitioners. In addition to her superior teaching, Dr.
Baker is also actively involved in numerous scholarly
activities, including publications and presentations, and
participates in many service initiatives.
Lillian B. Smith Award – Donna Everett
Ms. Donna Everett is currently an
Infection Control Preventionist at
Huntsville Hospital. Ms. Everett
is a long-term member of District
1 of the Alabama State Nurses
Association where she has served
as a delegate and in officer roles
of Secretary and President. Most
recently, Ms. Everett has served
as the Secretary at the state level
for the Alabama State Nurses
Association. In addition, Ms.
Everett writes a monthly newsletter that covers numerous
healthcare, safety, and disaster planning topics for
distribution in her community.
Outstanding Retired Nurse Award –
Rosemarie Juergensen
Since retirement from Huntsville
Hospital, Ms. Rosemarie
Juergensen has been active within
the Alabama State Nurses
Association and her community.
Ms. Juergensen serves on the
Alabama State Nurses
Association Ethics Committee
and spends a great deal of time
promoting the living will in her
community. Ms. Juergensen
frequently serves as a delegate for
District 1 at Convention and often mentors new nurses
entering the profession.

Page 12 • Alabama Nurse November, December 2020, January 2021
Visit nursingALD.com today!
Search job listings
in all 50 states, and filter by location and credentials.
Browse our online database of articles and content.
Find events for nursing professionals in your area.
Your always-on resource for nursing jobs, research, and events.
Convention Highlights
LIGHTS, CAMERA…ACTION!
Nurses in the Spotlight
September 24, 2020 - The Alabama State Nurses
Association was Honored to be the selection panel for
AL.com’s TOP TEN ALABAMA NURSES
September 25, 2020 – The Alabama State Nurses
Association hold its first ever… VIRTUAL HOUSE OF
DELEGATES
The TOP TEN NURSES awards, initiated by AL.com,
had over 500 nominations submitted for nurses across the
state! A committee of administrators and CEO’s narrowed
that group down to 50 and the ASNA awards committee
was asked to select the TOP TEN. We celebrated their
achievements and service at a “socially distanced” banquet
on the 24th. The event was live streamed to thousands of
viewers.
On the 25th, the cameras were back in action
with ASNA’s first ever VIRTUAL HOUSE OF
DELEGATES. Presentations were made by ASNA
President Sarah Wilkinson-Buchmann, ASNA Executive
Director Dr. John Ziegler, ASNA Treasurer, Dr. Frankie
Wallis and ASNA Awards narrated by President-elect Dr.
Lindsey Harris. After giving his Membership Growth
Report, ASNA Vice President, Fredrick Richardson
and was asked by Dr. Wilkinson-Buchmann to stay at
the podium. She then presented Fredrick with the first
Don Eddins Advocacy Award from the Alabama Nurses
Foundation. This honor and award carried with it a $3,000
stipend for his advocacy and community service! The
highlight of the evening for many was the introduction of
Dr. Lindsey as the new ASNA President. Dr. Harris is
the first person of color to hold the office of president in
ASNA’s 107-year history!
Enjoy the pictures from the two events and many thanks
to our sponsors!

November, December 2020, January 2021 Alabama Nurse • Page 13
Convention Highlights
ASNA Officers and Staff go over preliminary
VIRTUAL agenda before House of Delegates
begins.
ASNA Vice President receives the first Don Eddins
Advocacy Award during the Virtual House of
Delegates. Left is Dr. Lindsey Harris and right is Dr.
Sarah Wilkinson-Buchmann.
ASNA President Dr. Sarah Wilkinson-
Buchmann (left) passes the gavel to
incoming President Dr. Lindsey Harris.
ASNA delegation at the AL.com banquet celebrating
Alabama's TOP TEN NURSES.
ASNA officers at the AL.com banquet celebrating Alabama's TOP TEN NURSES. Left to
right are: Vice President, Fredrick Richardson, Pres-elect (now president) Lindsey Harris,
President, Sarah Wilkinson-Buchmann, Treasurer, Frankie Wallis, District 3 President,
Adriane Curry and Executive Director, John Ziegler.

Page 14 • Alabama Nurse November, December 2020, January 2021
Convention Highlights
Gold Sponsors:
Silver Sponsors:
Columbus State University - https://emajor.usg.edu/degrees/rnbsn/?utm_source=referral&utm_medium=sponsorship&utm_
campaign=asna&utm_term=fa_20
Middle Tennessee School of Anesthesia (MTSA) -
https://mtsa.edu/
Arthur Davis Publishing, LLC - nursingALD.com
Samford Moffett SON - https://www.samford.edu/nursing/
Jackson Hospital - www.jobsatjackson.org
Auburn University School of Nursing -
https://cws.auburn.edu/nursing
Troy University SON - troy.edu/nursing
Legacy of Hope - www.legacyofhope.org
The University of Alabama Capstone College of Nursing -
https://nursing.ua.edu/?page_id=14
Huntsville Hospital -
https://www.huntsvillehospital.org/careers
University of South Alabama College of Nursing -
https://www.southalabama.edu/colleges/con/
Holiday Greetings
from the Board & Staff
of Alabama State
Nurses Association

November, December 2020, January 2021 Alabama Nurse • Page 15
Dr. Lindsey Harris Receives Awards
UAB Medicine and
UAB School of Nursing
Samford University
At a reception at UAB Medicine in honor of Dr.
Lindsey Harris, she received the Excellence in
Leadership Award on Thursday, November 12,
2020. (Dr. Harris is pictured with her parents)
Dr. Lindsey Harris, President of the Alabama State Nurses Association was awarded
OUTSTANDING YOUNG ALUMNA AWARD for her leadership and achievements in nursing.
(Dr. Harris is pictured with other award winners in the Virtual Celebration on November 12, 2020)
To access electronic copies of the
Alabama Nurse, please visit
http://www.nursingald.com/
publications

Page 16 • Alabama Nurse November, December 2020, January 2021
CBD Oil and Chronic Pain
Susan E. Collins,
RN, BSN, MBA
Reprinted with permission from ANA-Maine Journal
May 2020 issue
Thesis statement: Cannabidiol (CBD) oil is an
effective means to treat chronic pain in adults.
Purpose statement: Chronic pain is a growing issue
in the United States and worldwide. This paper will
examine current studies completed within the last five
years on the use of CBD oil, or a combination of oils
to include CBD oil, for pain management (Smith 2019)
of chronic pain. A brief description on the epidemic
of chronic pain in relation to several conditions,
such as cancer, neuropathic pain (Smith 2019), and
musculoskeletal pain will be given, noting the current
traditional methods of treatment. Current research
will be reviewed and discussed in the use of CBD oil,
or a combination treatment including CBD oil, noting
findings, current results, and potentials for future
studies.
Abstract
Chronic pain is a growing issue in the United States
and worldwide. This paper examined current studies
completed within the last five years on the use of
Cannabidiol oil, or a combination of oils to include
Cannabidiol oil, for pain management (Smith 2019)
of chronic pain. A brief description on the epidemic
of chronic pain in relation to several conditions,
such as cancer, neuropathic pain (Smith 2019), and
musculoskeletal pain will be given, noting the current
traditional methods of treatment. Current research will be
reviewed and discussed in the use of Cannabidiol oil, or a
combination treatment including Cannabidiol oil, noting
findings, current results, and potentials for future studies.
Several current studies completed within the
last five years focused on Cannabidiol oil as a
standalone or adjunct treatment for chronic pain in
adults. Combinations of Cannabidiol oil and delta-9-
tetrahydrocannabinol (THC) were used in most studies,
however, dosing was found to be inconsistent, patient
samples generally small, and repeat studies non-existent.
With continued legislation changes and lack of Food
and Drug Administration involvement in Cannabidiol
oil products, Cannabidiol oil remains a viable option for
use in the spotlight of the general public, but with little
backing from the scientific community.
Keywords: cannabinoids, cannabidiol, cannabis,
CBD, delta-9-tetrahydrocannabinol, THC, pain, chronic
pain, pain management
Introduction
CBD oil advertisements are cropping up in window
fronts, convenience stores, video stores, the local gas
station, and everywhere that people routinely shop.
Amazing results are touted, by manufacturers, from
“natural” CBD products and oils. CBD oil is being
marketed to those with chronic pain, multiple sclerosis,
seizures or epilepsy, anxiety, mental disorders, and a
multitude of medical conditions, often those that are
chronic. It offers a ray of hope to those who seek a more
“natural” remedy and to those who are tired and feel
they have few options left.
CBD oil and THC are derived from the same plant.
THC is the element that causes a high, or euphoric
feeling, while CBD oil typically is considered safe and
non-intoxicating. Due to the individuality of plants, it is
difficult for manufacturers to standardize the amounts
of THC or CBD in over the counter or prescription
products, since no two plants are completely identical.
This has caused a significant issue with testing of
these products in medical studies, as has the issue of
legalization of the products in many states or countries.
CBD oil is available in a variety of forms, including
oils, tinctures, edibles, gummies, rubs, lotions,
capsules, tablets, and even aerosolized. Dosing is not
standardized, and there is no government recommended
daily allowance available, so the consumer must either
research or believe what is printed on the products or
advertisements. This study hopes to shed light on some
of the current research being done on the use of CBD
oil, in its various forms and combinations, in an effort to
educate the consumer and give support to further study
in the use of CBD oil for chronic pain.
Several products that combine CBD and THC are
available in various countries by prescription. These
include Bedrocan (THC/CBD), Tilray (THC/CBD),
Sativex (THC/ CBD), Epidiolex (CBD), Dronabinol
(THC), Nabilone (THC), as well as several nonmedicinal
formulations. The majority are derived from
the natural plant, but there are synthetic variations
available.
Current research studies offer a glimpse into the use
of CBD oil as a combination therapy with THC, and a
few support CBD oil as a singular, standalone therapy.
However, there are few follow up studies available, a
lack of legalization of THC or CBD products in many
countries, and a lack of standardization in dosing
that has caused a delay in studies or prevented them
altogether.
An Italian study conducted in 2017 (Fanelli et al.)
looked at the treatment of chronic pain in 614 adults,
who suffered from a variety of conditions. They used a
combination of CBD and THC, in oral and vaporized
forms, in patients who were running out of options and
had tried numerous therapies and treatments, but with
no avail. The inclusion of the CBD oil and THC therapy
seemed to serve as an “effective and safe” means of
treating chronic pain in this sample.
A separate study by Mondello et al. (2018) looked at
an 11-patient sample, suffering from neuropathic pain
at a singular Italian clinic, after being diagnosed with
“failed back surgery syndrome.” The small sample group
had used spinal cord stimulation with little success. The
inclusion of a combination of CBD and THC greatly
improved their pain relief when used as an adjunct to
spinal cord stimulation.
A very small study with promising results was
completed by Kiefer, D. (2017). Its focus was on the use
of “topical cannabis for wound pain.” The sample size
was three and the treatment was an infused sunflower
oil and cannabis combination applied topically to
wounds. Overall results revealed that the treatment
produced impressive results when looking at a decrease
in overall pain scores and a decrease in opioid use. This
retrospective study seeks to support the thesis statement
that cannabidiol (CBD) oil is an effective means to treat
chronic pain in adults.
Results
Should CBD Be Part of My Patients Treatment was
an original research study from Dick Benson (2019).
The objective of this study was to educate the provider
or practitioner on the endocannabinoid system, its
importance to the human body, and its functioning
and maintenance of homeostasis, while discussing
various dosages that can be effective for a moderate
list of medical conditions based upon research review.
He wanted to emphasize the benefits of CBD oil
and promote the use of it as a legitimate and legally
recognized treatment in the medical community. His
research findings validated the importance of the
endocannabinoid system to the health of the human body
and the use of CBD as an effective treatment or adjunct
treatment for pain, anxiety, digestive issues, mood
stabilization, and other common patient complaints.
Mondello et al. (2018) completed research on the use
of delta-9-tetrahydrocannabinol (THC) and cannabidiol
(CBD) of patients with “failed back surgery syndrome
(FBSS)” and the treatment of refractory pain. The
authors treated the participants with an oral combination
of THC and CBD as an effective alternative treatment
for chronic refractory pain in patients with FBSS when
used as an adjunct to spinal cord stimulation (SCS). The
researchers performed a retrospective study on patients
who were treated with a combination of THC and CBD
while using SCS for twelve consecutive months, in an
effort to diminish/manage pain, improve participants
quality of life, and functional ability following the
development of a chronic refractory pain condition post
back surgery. Findings revealed a significant reduction
in pain when compared to the participants initial rating
of their pain and functioning with only SCS. This
suggested enhanced pain relief, improved function, and
an overall improved quality of life for the participant,
thus provided significant support for the use of THC and
CBD as an adjunct for pain control.
Effective cannabinoid use for the treatment of
chronic pain was explored by Fanelli et al. (2017)
through a retrospective study of 614 Italian patients.
The focus of the study was to evaluate the use of
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November, December 2020, January 2021 Alabama Nurse • Page 17
9-tetrahydrocannabinol (THC) and CBD use for the
treatment of several chronic pain conditions, after the
Italian government approved the use of cannabis for
legalized use for treatment. A specific pain modality
of oral ingestion was the focus, as it was noted that this
was the primary treatment prescribed by practitioners.
Results revealed that THC and CBD were effective in
treating chronic pain, but noted that many patients still
continued using their previously prescribed treatment.
This would suggest that THC and CBD would be a
successful adjunct therapy versus a standalone treatment.
In 2016, a Canadian study was completed and
published in the Journal of Pain Research by Ko,
G.D., Bober, S. L., Mindra, S., and Moreau, J. M., that
reviewed the barriers and concerns of THC and CBD use
in the Canadian healthcare system for the treatment of
chronic pain. A systematic review of available research,
discussed cannabis, concerns for its use, legalization,
prescribing methods, social concerns, availability of
various preparations of cannabis, and medical cannabis
regulations effecting or influencing Canadian citizens
utilizing THC and CBD preparations from a prescribing
practitioner. The authors came to the conclusion
that with education and evidenced based treatment
approaches, practitioners can safely and effectively
utilize cannabis, THC, and CBD for the treatment of
pain and reduce the use of narcotics.
In November of 2018, “unlicensed cannabis based
products” were able to be prescribed in the United
Kingdom, as cited in a systematic review completed
by Freeman, T. P., Hindocha, C., Green, S. F., &
Bloomfield, M. A. P. Six available products authorized
in the United Kingdom, were compared based upon
prescribing standards, licensed indications, and
authorized prescribers. Authors wanted to provide
education and discuss the various implications
associated with the six drugs with emphasis on use in
the United Kingdom, but noted considerations and some
comparisons with other developed countries. Much
discussion was provided on legal considerations and
variation in products, revealing minimal standardization
requirements for those products sold over the counter.
Results noted that cannabis, THC, and CBD are being
used for the treatment of chronic pain, with varying
degrees of success as cited in 14 studies with a total
of 2978 participants involving a singular prescribed
commercial product containing a combination of THC
and CBD (Sativex).
An interesting, yet very limited research study,
completed by David Keifer in 2017, demonstrated the
usefulness of a topical cannabis (a combination of THC
and CBD) for the treatment of pain in three patients
with gangrene. Traditional treatments, opioids, and
combinations therapies, had demonstrated little benefit
to the patients, so Keifer opted for a non-conventional
approach experimenting with new products. Results were
found to be significant in two of the three participants,
with other benefits noted to be reduced opioid use in two
patients. This study was small, but could possibly lead
the way for further controlled studies.
The majority of studies reviewed, strongly suggested
and encouraged the completion of more randomized
clinical trials to be completed distinguishing the effects
of THC versus CBD versus other active components
of cannabis to demonstrate the best combination
for treatment modalities. Several authors noted that
due to legal considerations and regulations in many
countries, randomized trials and research were difficult
to complete. It was felt that without further study, no
conclusive dosage, preparation, combination therapy,
or evidence could be finalized that best supported the
individual patient or treatment of chronic pain.
Discussion
There is evidence to support that CBD oil is an
effective treatment for chronic pain in adults, however
not enough was found to support it as a standalone
treatment. Most research has been on CBD oil combined
with another oil, therapy, or substance, or used in
combination with a different treatment regimen. This
leads to the evidence more strongly supporting CBD oil
as an adjunct therapy for chronic pain in adults.
CBD oil is available in various forms, including
lotions, creams, oils, food products, vaporized oils, and
oral pharmaceutical variations. There is currently no
standardized dosage or one size fits all recommended
amount of CBD oil to use topically, orally, or vaporized.
CBD oil is extracted from the hemp plant (Cannabis
sativa L). You will not find two identical plants, thus the
CBD oil extracted can have various amounts of THC
present and other constituents. A limiting factor is if
too much THC is present in extracted CBD oil, then it
cannot be sold legally in many states or countries, for it
would be considered marijuana. This would limit who
could or would study it.
Another consideration that still requires further
study is the influence of individual human factors and
variations on plant factors that can greatly influence
or deter the potential benefits of CBD oil. Groups of
individuals that participated in the current research
were chosen based upon a single disease or condition
predominately. Considerations for human factors such
as weight, genetics, metabolism, plant factors such as
environment, climate, or processing factors such as
inconsistent manufacturing practices or processes that
go into creating a CBD product were not addressed, thus
further limiting support.
Due to CBD oil popularity and “newness,” charlatans
and opportunistic salesmen are promoting CBD curealls
with little or questionable research available for
the average person. CBD is proudly advertised at the
local drug store, video store, health food chain, and it
continues to pop up all over the country. The promise
of miraculous cures, and healing properties from CBD
infused foods, body products, oils, and numerous other
creations, pique the curiosity of the average consumer,
and offer hope to the chronic pain sufferer. Yet the
science does not support these products and research is
still in its early stages predominately due to legal issues
surrounding the THC portion of the Cannabis sativa L
plant.
According to GOVERNING, as of June 25, 2019, in
the United States, the District of Columbia and 11 states
have passed laws into place that legalize marijuana
for recreational use. In the past ten years, the United
States and many countries, have seen a trend and felt the
push, by citizens and consumers, to legalize marijuana
and make it available for use by the common man for
self-medication and recreation. Prior to this, research
on CBD oil was very difficult to complete because it
came from the same “illegal” plant known as marijuana,
thus was not readily available for study and did not have
the funding sources needed to complete studies that
would be respected and well received by the medical
community.
To sum things up, CBD oil is promising. It has been
found to help relieve pain, and various other chronic
symptoms in smaller studies for different types of
chronic pain in adults. When combined with THC or
used as a supportive therapy to an already established
treatment, it has proven to be beneficial in helping
to diminish pain and improve the functionality and
quality of life in adults with chronic pain. It is worth
consideration for further study to examine its benefits in
larger adult studies, as a standalone treatment, as well as
a combination treatment. Once this has been completed,
hopefully a standardized dosing system or usage will
be approved by the Food and Drug Administration for
use to in adults to provide relief for chronic pain in its
many forms. Hope for an improved quality of life with
less pain is a possibility through the use of CBD oil for
adults with chronic pain.
Conclusions
Alternative medicine is still a new and developing
concept to westernized medicine practitioners, but it
is making head way in being accepted as a possible
treatment for chronic conditions, including adult pain
syndromes. With the legalization of marijuana in several
states in the United States, and several countries, the use
of CBD oil, THC, and cannabis has been a focus in the
medical community and public. CBD oil is considered
generally safe as an alternative treatment therapy which
has promoted its use.
CBD oil is generally combined with THC or cannabis
as an alternative treatment modality. Many participants
in current studies would continue current treatments
during the trialed CBD oil and THC or cannabis
combined therapy. So, it is unclear if the CBD oil and
THC or cannabis combined therapy worked well on
its own or had a positive or complementary effect on
the current westernized treatment already in progress.
The use of a combination therapy of administered
CBD oil and THC shows great promise as an effective
therapy for chronic pain. However, further research
needs to be completed to support the CBD oil/THC
combined therapy due to a low number of participants
and lack of standardized oils, dosages, and methods
of administration. The legal aspects still surrounding
marijuana in many countries and states, also greatly
limits research. CBD oil is indeed promising, but at
this time, the thesis that Cannabidiol (CBD) oil is an
CBD Oil continued on page 19

Page 18 • Alabama Nurse November, December 2020, January 2021
Loneliness and Social Isolation
Cause Emotional Pain in the Elderly
Karra Harrington and
Martin J. Sliwinski
** This article was published in The Conversation,
a free on-line newsletter. “We believe in the free flow of
information. Republish our articles for free, online or
in print, under a Creative Commons license.” Read the
newsletter at www.theconversation.com
Maintaining high quality relationships may be a key
for protecting brain health from the negative impacts of
loneliness. The loneliness of social isolation can affect
your brain.
Physical pain is unpleasant, yet it’s vital for survival
because it’s a warning that your body is in danger. Pain
tells you to take your hand off a hot burner or to see a
doctor about discomfort in your chest. Pain reminds us all
that we need to take care of ourselves.
Feeling lonely is the social equivalent to feeling
physical pain. It even triggers the same pathways in the
brain that are involved in processing emotional responses
to physical pain.
Just like feeling physical pain, feeling lonely and
disconnected from others is also a signal that we need to
take care of ourselves by seeking the safety and comfort of
companionship. But what happens when we are unable to
find companionship and the loneliness persists?
As scholars at the Center for Healthy Aging at Penn
State, we study the impact of stress on the aging body
and brain, including how it can worsen cognitive decline
and risk for dementia. The social isolation older adults
are experiencing now amid the coronavirus pandemic is
raising new mental health risks, but there are things people
can do to protect themselves.
The health consequences of loneliness
The COVID-19 pandemic has put many older
adults’ social lives on hold, leaving them at greater risk
for loneliness. They know they face a higher risk of
developing severe symptoms from COVID-19, so many are
staying home. Restaurant closures and limits on visitors to
assisted living centers have made it harder to see family
and friends.
But even prior to the pandemic, public health experts
were concerned about the prevalence and health impacts
of loneliness in the U.S. Loneliness affects between 19%
and 43% of adults ages 60 and older, and many adults
ages 50 and over are at risk of poor health from prolonged
loneliness.
Research has shown that prolonged loneliness is
associated with increased risk for premature death, similar
to smoking, alcohol consumption and obesity. Other
health consequences are also associated with loneliness,
including elevated risk for heart disease and stroke,
and it is associated with increased physician visits and
emergency room visits.
Loneliness can affect brain health and mental
sharpness
Older adults who are socially isolated or feel lonely
also tend to perform worse on tests of thinking abilities,
especially when required to process information rapidly.
Moreover, those who feel lonely show more rapid
decline in performance on these same tests over several
years of follow-up testing.
It is thought that loneliness may contribute to cognitive
decline through multiple pathways, including physical
inactivity, symptoms of depression, poor sleep and
increased blood pressure and inflammation.
Loneliness has also been found to increase the risk
of developing dementia by as much as 20%. In fact,
loneliness has an influence similar to other more wellestablished
dementia risk factors such as diabetes,
hypertension, physical inactivity and hearing loss.
Although the underlying neural mechanisms are not
fully understood, loneliness has been linked with the
two key brain changes that occur in Alzheimer’s disease:
the buildup of beta-amyloid and tau proteins in the
brain. Other indicators of psychological distress, such as
repetitive negative thinking, have also be linked with the
buildup of beta-amyloid and tau in the brain. Theories
suggest that loneliness and other psychological stressors
act to chronically trigger the biological stress response,
which in turn appears to increase beta-amyloid and tau
accumulation in the brain.
How loneliness can contribute to disease
The evidence suggests that prolonged feelings of
loneliness are detrimental to health. So, how do those
feelings get converted into disease?
Feeling lonely and socially isolated can contribute to
unhealthy behaviors such as getting too little exercise,
drinking too much alcohol and smoking.
Loneliness is also an important social stressor that can
activate the body’s stress responses. When prolonged, that
response can lead to increased inflammation and reduced
immunity, particularly in older adults. Inflammation is the
body’s response to fight off infection or heal an injury, but
when it continues unchecked it can have a harmful impact
on health. Stress hormones play an important role in
making sure that inflammation doesn’t get out of control.
But, under chronic stress, the body becomes less sensitive
to the effects of the stress hormones, leading to increased
inflammation and eventually disease.
In healthy older people, loneliness is related to a stress
hormone pattern similar to that of people who are under
chronic stress. This altered pattern in the stress response
explained why people who were lonelier had poorer
attention, reasoning and memory ability.
Social activity can buffer against the decline
Maintaining high quality relationships may be a key
for protecting brain health from the negative impacts of
loneliness.
Older adults who feel more satisfied in their
relationships have a 23% lower risk of dementia, while
those who feel their relationships are supportive have a
55% lower risk of dementia, compared to those who feel
dissatisfied or unsupported in their relationships.
Maintaining social activity also buffers against decline
in thinking abilities, even for those who live alone or
who have signs of beta-amyloid accumulation in their
brain. One reason for these benefits to brain health is that
maintaining strong social ties and cultivating satisfying
relationships may help people to cope better with stress;
people who feel better able to cope with difficulties or
bounce back after a stressful event show less buildup of
tau protein in their brains.

November, December 2020, January 2021 Alabama Nurse • Page 19
This is good news because, with the importance of
social distancing for controlling the COVID-19 pandemic,
how people manage their feelings and relationships is
likely more important for brain health than the fact that
they are spending time physically apart.
Strategies for coping with loneliness
Loneliness is a common and normal human experience.
An important first step is to recognize this and accept that
what you are feeling is part of being human.
Rather than focusing on what’s not possible at the
moment, try to refocus your attention on what you can do
to stay connected and make a plan to take action. This
could include planning to reach out to friends or family, or
trying new activities at home that you normally wouldn’t
have time for, such as online classes or book clubs.
During times of high stress, self-care is essential.
Following recommendations to maintain regular exercise
and sleep routines, healthy eating and continuing to engage
in enjoyable activities will help to manage stress and
maintain mental and physical health.
Karra Harrington is a Postdoctoral Research Fellow,
Clinical Psychologist, at Pennsylvania State University.
Martin J. Sliwinski is the Professor of Human
Development and Family Studies, Director of the Center
for Healthy Aging, at Pennsylvania State University.
CBD Oil
continued from page 17
effective means to treat chronic pain in adults is not
supported as a standalone treatment.
References:
Smith, K. (2019). What is CBD Oil … and why are we talking
about it so much? Environmental Nutrition, 42 (8), 7.
Retrieved from: https://search.proquest.com/docview/22544
74489?accountid=158302
GOVERNING The States and Localities (June 25, 2019) State
Marijuana Laws in 2019 Map Retrieved from: https://www.
governing.com/gov-data/safety-justice/state-marijuanalaws-map-medical-recreational.html
Benson, D. (2019). Should CBD Be Part of My Patients’
Treatment? Alternative Therapies in Health and Medicine,
25 (1), 8-11. Retrieved from: https://search.proquest.com/do
cview/2261146571?accountid=158302
Mondello, E., Quattrone, E., Cardia, L., Bova, G., Mallamace,
R., Barbagallo, A.A., Mondello, C., Mannuccvi, C., Di
Pietro, M., Arcoraci, V., Calapai, G. (2018). Cannabinoids
and spinal cord stimulation for the treatment of failed
back surgery syndrome refractory pain. Journal of Pain
Research, 11, 1761-1767. doi: 10.2147/JPR.S166617
Fanelli, G., Carolis, G. D., Leonardi, C., Longobardi, A.,
Sarli, E., Allegri, M., & Schatman, M. E. (2017). Cannabis
and intractable chronic pain: An explorative retrospective
analysis of Italian cohort of 614 patients. Journal of Pain
Research, 10, 1217-1224. doi:http://dx.doi.org/10.2147/JPR.
S132814
Ko, G. D., Bober, S. L., Mindra, S., & Moreau, J. M. (2016).
Medical cannabis - the Canadian perspective. Journal of
Pain Research, 9, 735-744. doi:http://dx.doi.org/10.2147/
JPR.S98182
Freeman, T. P., Hindocha, C., Green, S. F., & Bloomfield, M.
A. P. (2019). Medicinal use of cannabis based products and
cannabinoids. BMJ: British Medical Journal (Online), 365
doi:http://dx.doi.org/10.1136/bmj.l1141
Kiefer, D. (2017). Topical cannabis for wound pain: A case
series. Integrative Medicine Alert, 20, (12) Retrieved from:
https://search.proquest.com/docview/1978189964?account
id=158302
Teitelbaum, J. (2019). A hemp oil, CBD, and marijuana
primer: Powerful pain, insomnia, and anxiety-relieving
tools! Alternative Therapies in Health and Medicine, 25,
21-23. Retrieved from https://search.proquest.com/docview
/2261140637?accountid=158302
Blake, A., Wan, B.A, Malek, L., DeAngelis, C., Diaz, P., Lao,
N., Chow, E., O’Hearn, S. (2017). A selective review of
medical cannabis in cancer pain management. Annals of
palliative medicine, 6 (Suppl 2), S215-S222. doi:10.21037/
apm.2017.08.05
Cicchi, R., Sturiale, A., Nesi, G., Kapsokalyvas, D.,
Alemanno, G., Tonelli, F., Pavone, F. (2013). Multiphoton
morpho-functional imaging of healthy colon mucosa,
adenomatous polyp and adenocarcinoma. Biomedical
Optics Express 4 (7) 1204-1213. doi: 10.1364/
BOE.4.001204