Nevada RNformation - December 2020

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December 2020 • Volume 30 • Number 1

www.nvnurses.org

Nevada

RNFORMATION

Inside

articles

2 Preparing Patients for COVID-19

Vaccination

3 Trickle Charge Your Self-Care

During This Ongoing Crisis

4 NNA’s Current and New Members

THE OFFICIAL PUBLICATION OF THE NEVADA NURSES ASSOCIATION

The Nevada Nurses Association is a constituent member of the American Nurses Association

Quarterly publication direct mailed to approximately 1,000 RNs and LPNs and

delivered electronically via email to 40,000 RNs and LPNs in Nevada

RED ROCK CANYON

CLARK COUNTY, NEVADA

The President’s Message

5 Loneliness and Social Isolation

Cause Emotional Pain in the

Elderly

7 Taking Time for Self-Care during

COVID

11 Healthy Nurses

12 Addressing Sleep Problems During

the COVID-19 Pandemic

13 Nurses in the News

15 The 20/20 Vision: Nevada

Nursing Student Association

Empowerment

16 UMC Annual Research

Empowerment Day 2020 - Virtual

Edition

regular features

6 Research & EBP Corner

Mary Bondmass, Ph.D., RN, CNE, President,

Nevada Nurses Association

Mary.bondmass@unlv.edu

As we move into 2021, many

issues continue to confront

us as nurses individually and

collectively as a profession. The

relentless severe acute respiratory

syndrome coronavirus 2 (SARS-

CoV-2), which causes COVID-19,

has been a continued stressful

presence since March of 2020,

and unfortunately, it is still with

us. However, as we welcome in

the new year, there is hope in

several vaccines, yet there is much to be done before we

even approach getting back to 'normal,' whatever that is.

In a recent NNA Board meeting, my colleagues

and I discussed the pandemic, the current staggering

numbers of infected people in Nevada, subsequent

hospitalizations, and ultimately deaths in some cases. You

may or may not know, but your NNA Board consists of

an eclectic group of nursing faculty, public health and

hospital administrators, retired practitioners, front line

staff nurses, and advanced practice registered nurses

(APRNs). In our recent discussion, all expressed sentiments

of being overwhelmed and somewhat helpless and

sometimes hopeless about what more we could do given

the pandemic's current state; these feelings seemed the

same, no matter which area of nursing we respectively

represented.

NNA has implemented several initiatives, including

providing COVID-19 education on our website (from

the CDC and ANA), developed a non-staff nurse

volunteer database, and purchased and distributed

personal protective equipment (PPE) to Nevada nurses.

Still, as the number of COVID-19 cases continued to

grow, we asked ourselves what else we could do.

Despite the good news of vaccines, we know that

the dire situation and the COVID-19 strain on individual

nurses and the entire Nevada healthcare system may

continue well into 2021 and may even get worse

before it gets better. So what else? We came up with a

few other engaging ideas in our Board discussion, and I

want to share them with the entire RNF readership.

As nurses, anyone of us could make sure we stay

informed of the most recent, evidence-based facts of

COVID-19 and correct misinformation whenever and

wherever it occurs (and unfortunately, there is still

a lot of misinformation out there). While the world

learns more about this novel virus and information

rapidly changes, please use the NNA website to

access this free and accurate COVID-19 information.

Once we have the facts, we could disseminate those

The President’s Message continued on page 2

8 NNA Environmental Health

Committee

10 Antimicrobial Stewardship -

Infection Prevention

17 Leadership in Policy and Care

Quality and Safety

18 Nevada Nurses Foundation

Volunteers Needed

SERVNV.ORG

Help is needed to distribute the Covid vaccines.

Please consider volunteering.

current resident or

Presort Standard

US Postage

PAID

Permit #14

Princeton, MN

55371

Mark Your Calendars

• 2-day Elko virtual Fundraiser/Symposium

CEUs available!

January 21 (5-8pm) & January 22 (8-12)

• Nurses Day at the Legislature - March 2, 2021

Vaccine Volunteers Needed!


Page 2 • Nevada RNformation December 2020, January, February 2021

NNA Mission Statement

The Nevada Nurses Association promotes professional nursing practice through Preparing Patients for COVID-19

continuing education, community service, nursing leadership, and legislative

activities to advocate for improved health and high quality health care for citizens of

Vaccination

Nevada.

NNA State Board of Directors

Mary D. Bondmass, PhD, RN, CNE Mary.bondmass@unlv.edu ..............President

Nicki Aaker, MSN, MPH, RN, CNOR, PHCNS-BC naaker@aol.com .......Vice President

Sherrie Sherk-Olson, BSN .........................................Secretary

Glenn Hagerstrom, PhD, APRN, FNP-BC, CNE ghagersrom@unr.edu .........Treasurer

Arvin Operario ...........................................Director at Large

Christa Secord, MSN, FNP-BC cjsecord@gmail.com ................Director at Large

Norman Wright, RN, BSN, MS info@f441.com ...................Director at Large

Darlene Bujold, BSN, RN darlene.cbrn@gmail.com ...............President, District 1

Margaret Covelli, DPN, RN Margaret.covelli@umcsn.com ..........President, District 3

Editorial Board

Managing Editor, Linda Bowman, RN, lbowman@nvnurses.org

Print Editor, Kathy Ryan, MSN, RN-BC

Mary D. Bondmass, PhD, RN, CNE

Tracey Long PhD, APRN-BC

Lisa Pacheco, MSN, RN

Bernadette Longo, PhD, RN, FAAN

Vicki Walker DNP, BS RN

Are you interested in submitting an article for publication in RNFormation?

Please send it in a Word document to us at lbowman@nvnurses.org. Our

Editorial Board will review the article and notify you whether it has been

accepted for publication.

If you wish to contact the author of an article published in RNFormation,

please email us and we will be happy to forward your comments.

www.nvnurses.org

Published by:

Arthur L. Davis

Publishing Agency, Inc.

Susan S. VanBeuge, DNP, APRN, FNP-BC, FAANP

Over the past ten months, the world of practice has

changed for all providers, from hospital service to outpatient

care. One common theme discussed has been the anticipation

of a vaccine for COVID-19. Vaccine distribution is expected

in late 2020 and early 2021 throughout the United States

and the world. Distribution and allocation are planned by

the Centers for Disease Control and Prevention (CDC, 2020).

There are five phase-3 clinical trials for a COVID-19 vaccine in

the United States at the time of this writing.

In my practice, reviewing immunization status is the

norm, but this year my assessment has considered the

upcoming COVID-19 vaccine. Reminders of updating the flu

vaccine are standard during encounters in the season, and then the conversation is

followed by education about the COVID-19 vaccine. Utilizing the CDC's resources, I

have been able to incorporate teaching and preparation for my patients. I've noted

many patients express concern, and more than a few are hesitant to commit to

taking the vaccine once it is available.

The CDC offers providers resources to engage in a compelling conversation about the

COVID-19 vaccine with their patients. There are five techniques and strategies suggested

to start the vaccine's conversation with your patients (table 1). The recommendation is to

start from a place of understanding and empathy, assume they will want a vaccination

but may have limited knowledge, give your strong recommendation as their provider,

listen and respond, and summarize the discussion (CDC, 2020).

Table 1

Questions

1. Start from a place of empathy and understanding.

2. Assume patients will want to be vaccinated but may not know what to expect.

3. Give your strong recommendation.

4. Listen to and respond to patient questions.

5. Wrapping up the conversation.

https://www.cdc.gov/vaccines/hcp/covid-conversations/engaging-patients.html

As we navigate our patients' questions, concerns, and fears, we can equip

ourselves with updated information regarding the vaccine and distribution plans

within the community. One aspect of the COVID-19 pandemic that has become

clear is how vulnerable patients feel about the virus and the unknown future, which

may cause uncertainty with the vaccine. Directing patients to reputable sources to

learn details and information will increase confidence. The CDC suggests strong

recommendations coming from their healthcare provider are critical for vaccine

acceptance. Sharing vaccines' importance to protect health and those in their

community may be important points to emphasize during the conversation.

As practice enters another phase of the COVID-19 pandemic, another aspect

of our roles evolves to incorporate education regarding the vaccine. Being firmly

grounded in understanding the science, efficacy, and distribution planned

to vaccinate the general population will enable practitioners to have these

conversations with individual patients. Presenting evidence-based information and

education within our patient community will provide a foundation for individuals

to make the best decisions for their health and well-being as we all continue to

navigate the COVID-19 pandemic.

Reference:

Centers for Disease Control and Prevention (2020). Talking to Patients about

COVID-19 Vaccines. Downloaded from https://www.cdc.gov/vaccines/covid-19/

hcp/talking-to-patients.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.

gov%2Fvaccines%2Fhcp%2Fcovid-conversations%2Ftalking-to-patients.html

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The President’s Message continued from page 1

facts. Nurses have gained increased credibility during this crisis, and nurses' words

may be meaningful and impactful to the public. This dissemination of facts could

perhaps take the form of writing an editorial for your local newspaper – speaking

to your experience with COVID-19 and the need for people to continue to protect

themselves and others against the virus. We can stop now; even just talking about

the facts of COVID-19 with relatives or friends can be powerful. It is hard to believe,

but still, some people do not know or believe that wearing a mask, washing our

hands, and social distancing are our best preventative weapons until, and maybe

even after, nearly all Nevadans become vaccinated against COVID-19. Sometimes we

may look for grand interventions when simple things like educating our patients and

the public may have a more significant effect.

In addition to our role in educating about the virus, we can model the same behavior

we extol. Just as our parents might have taught us, we need to ‘practice what we

preach.' With the new spotlight that the pandemic has brought to nurses, others will

look to us for advice, and our modeling of COVID-19 preventative behaviors is critical.

I often wonder if we had modeling behaviors from our national leaders back in early

2020, then maybe early 2021 might look different. Nevertheless, today is the situation

we have, and looking forward may be more productive than recounting our past

mistakes. Nurses can lead the way as we move through the new year.

Looking forward to a promising future for all Nevadans, I wish you and yours the

best in the new year.

Sincerely,

Mary D. Bondmass, Ph.D., RN, CNE

President, Nevada Nurses Association


December 2020, January, February 2021 Nevada RNformation • Page 3

Trickle Charge Your Self-Care During This Ongoing Crisis

Sherry Stofko, MSN, RN

Sherry practicing self-care in fresh air

A few months ago, I wrote an article about

how nurses were crumbling under the weight and

uncertainty of the COVID outbreak. I asked that you

give yourself “permission to fall apart.” Nurses were

down back then, but we typically don’t stay down

long. Has there been healing and growth since that

time? In the mild “downtime” over the summer, did

we use that time to build resilience and count our

blessings? Did we restore our psychological reserves?

Or did we waste time tallying our complaints against

weak institutional leadership and governmental bodies,

further eroding morale. Did healthcare administrators

use that time to plan and prepare for COVID 2.0, AKA

flu season PLUS an increase in coronavirus patients

fueled by more indoor activities and large-scale political

rallies? Seriously, it’s not like we didn’t know this wave

was coming.

Collectively, nurses are burning out in

unprecedented numbers. Eight months of tough

circumstances with little improvement will do that.

We are sick of seeing our coworkers kept alive on

ventilators. We can no longer bear to hold the cell

phone while families cry their goodbyes to our intensive

care patients. The smiles that used to soften our bad

days are obscured by tattered, poorly sealing N95's

that have been re-sterilized countless times since April.

Nurses are generally empaths and people-persons who

crave meaningful and unbridled relationships with

friends, family, co-workers, patients, and patients’

loved ones. The barriers of the face masks and

restricted physical contact further the loss of human

connection nurses so yearn for. To top it off, we are

now getting crash courses in crisis standards of care,

team nursing, disaster charting, and managing patients

on ventilators.

In the Spring and Summer, nurses felt dejected.

Now, talking to nurses on the front lines, they express

intense anger and frustration. They are “past the

sadness,” as one colleague stated, and understandably

so. Patients are incredibly ill. Units and hallways are

full. Patient-to-nurse ratios are worsening an already

intolerable situation. We're forced to work with

strangers floated to our unit who are not experienced

in our specialty and with whom we have no trusting

relationship. We work in unfamiliar locations with

equipment we’ve never seen before. Despite all this,

we still hold ourselves to the highest standards and

beat ourselves up when patient outcomes are less than

stellar, and the guilt decimates our soul. We dutifully

go back in for an extra shift, even though our crisis pay

bonuses are shrinking as the pandemic lingers on. We

complain about the staffing shortages, and when the

organization brings in travelers, we complain about

that as well.

What I see as the biggest issue is the relentless

feeling of anger fueled by being overwhelmed,

disrespected, devalued, disempowered, silenced. I feel

the same, and I no longer provide direct patient care.

I hear the cries of the bedside nurses who tell similar

stories: reusing single-use protective gear, supervisors

who won’t replace unsafe masks, broken equipment

not repaired. Many nurses who work in institutions

that are not being honored with comparable crisis pay

feel financially undervalued. Of course, hospital bottom

lines have been hit hard by this pandemic, and millions

of unbudgeted dollars have been spent on all sorts of

items and staff. We know that healthcare institutions

code for COVID and receive extra reimbursement

for COVID patients and COVID-related projects. We

ask, “Where is all this governmental funding going?”

because it’s certainly not being funneled to the

frontline staff working in the trenches, risking their lives

and the safety of their families. Healthcare has never

been so much a business as it is right now.

What to do about all this? Even with vaccines on the

way, we have a very long way to go in this pandemic.

We use our cherished thirty-minute break to complain

to and commiserate with staff about the horrible

situation we’re in. We pick up extra shifts when our

supervisors send the guilt texts about how the patients

or our co-workers need us. We are banging our heads

against the walls. We have virtually no control over

corporate America, government, and big pharma who

run this country’s healthcare system, so we need to

take charge when and where we can.

We do have control over our own thoughts,

actions, and reactions. Many nurses are leaving the

profession all together, tossing away their incredible

skill set to start a craft business on Etsy. Uncountable

healthcare workers are jumping ship and swimming

over to the hospital across town or on the other side

of the country. That other hospital is likely suffering the

same woes because American healthcare is broken,

not just your institution. The other facility may manage

differently with seemingly better administrators and

higher pay, but if we don’t have a handle on our own

way of managing uncertainty, anger, and our feelings

of being undervalued, we will find ourselves with the

same complaints in a new setting six months from

now. I wonder if all the people jumping on the travel

nurse band wagon understand what they’re getting

into. Having been a traveler from 1997 – 2006, I know

very well the isolation, insecurity, incessant floating,

bullying, and lack of support that comes with those fat

paychecks. It’s not all rainbows and unicorns.

What are the alternatives? How do we survive

through this horrible pandemic and poor leadership?

Building your resilience and prioritizing your self-care

are paramount. Explore and practice ways to defuse

your anger or respectfully direct it at the appropriate

target. Start using your vacation time before mandatory

overtime is instituted. Don’t answer the calls or read

the texts on your off days. Exercise, stretch, meditate.

Eat decent foods and treat yourself to the cupcakes

now and then. Express gratitude. Tell your co-workers

how valuable they are to you, and why. Try finding

the silver lining; make a game of it. There must be

something good about being floated from NICU to

surgical-telemetry for 12.5 hours. Maybe it’s time

to explore nursing positions in new specialties away

from the bedside, far from the clutches of the Joint

Commission, corporate, unsafe staffing matrices, and

inadequate PPE. Most of the jobs outside direct patient

care require higher levels of education, especially the

ones that allow work from home. Academic degrees

seem to be a huge divider in this, now more than

ever. Maybe it’s time to seriously consider professional

development and growth through programs such

as Duke University’s Nurse Leadership Certificate or

Grand Canyon University’s RN-to-BSN program. Is your

head full of legitimate complaints about how poorly

healthcare is run? Get involved politically or with your

union, or you could write well-crafted letters to the

Nevada Hospital Association.

No matter how you choose to continue in your

career, there’s no question it will be stressful, and the

pandemic will be clouding our sunny skies for a while

longer. Self-care with a focus on learning to handle

recurrent adversities in a healthful way is vital. We

bash administration for not properly planning for 2.0,

but how well have you prepared? We don’t need a

jump start on self-care; it’s too late for that. We need

a trickle charge. What are you doing to trickle charge

your health and wellness?


Page 4 • Nevada RNformation December 2020, January, February 2021

NNA'S CURRENT AND NEW MEMBERS!!

Aaron Cook

Aaron Bellow

Abbie Purney

Abbigail Holman

Abigail Guevarra

Adaobi Ezeanolue

Aileen Thompson

Akeisha King

Alannah Bradley

Alba Velasquez

Alejandrina Diaz

Alexandria Crossley

Alexis Coe

Alexis Walberg

Aliah Metzger

Alijandra Cruz-Tokar

Alina Aidinova

Alisa Patton

Allison Saunders

Allison Basta

Alona Angosta

Alonzo Thornton

Althea Bongolan

Alyssa Alden

Amanda Stachlewitz

Amanda Carpenter

Amanda Frazier

Amanda Berumen

Amanda Tye

Amanda Tobey

Amanda Horton

Amanda Gant

Amanda Sweet

Amanda Novick

Amber Federizo

Amie Ruckman

Amy Hamtak

Amy Bitto-Lange

Amy Kunz

Amy Runge

Amy Sandstrom

Amy Hollingshead

Amy Cercone

Amy Lelenko-Cain

Amy Chaffin

Amy Lynch

Ana Rizzo

Anastasia Ludel

Andrea Travella

Andrea Felesina

Angela Holdridge

Angela Turner

Angela Mildon

Angela Hurt

Angela Brock

Angela Amar

Angela Shinoskie

Anita Kuo

Anna Apolonio

Anna Anders

Anna Smith

Anna Marie Zamora

Anne Wallace

Anne Margaret Bexon

Anne-Marie Schenk

Annette Asbury

Antionette Serrano

Antoinette Carlos

Antoinette Mullan

Antonette Vergara

Antonia McNamara

April Sullivan

April Daul

April Hontanosas

Ariana Johnston

Ariana Monin

Arkay Marie Lising

Arlene Diaz

Arlygen Ring

Arvin Operario

Ashley Akren

Ashley Rhoades

Ashley Swarowski

Athelda Abrams

Atheni Sevilla

Aubree Carlson

Audrey Hyland

Audry See

Autum Kapinkin

Autumn Gardner

Azeb Gebrekidan

Barbara Barrett

Barbara Parish

Barbara Schneider

Barbara Tanner

Barbara Carlton

Barbara Ruscingno

Barbara Gross

Beatrice Razor

Beatrice Sanders

Becky Czarnik

Becky Tisue

Beena Thomas

Bernadette Sisnorio

Bernadette Longo

Beth Unger

Beth Ennis

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Beverly Thielke

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Bonnie Carlisle

Bonnie Spears

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Brandee Shipman

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Cherry Grace Daelto

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Constanza Bridges

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Yamomo

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Gonzalez

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Jessica Povey

Jessica Bliven

Jessica Danyan

Jessica Harbauer

Jessica Richard

Jessica Valle

Jessica McIntosh

Jessyca Luke

Jesus V Cornelio Catre

Jhouleen Angelika

Tiamzon

Jiaqing Li

Jinyoung Kim

Joann Nardoni

Joann Bruno

Joann Rupiper

Joanna Valdes

Joanna Patrice Johnson

Joanne Cretney-Tsosie

Jodi Epp

John Coldsmith

Jon Arlien

Jon Failla

jonda Purper

Jordan Carley

Jordana Janjua

Jordyn Belli

Joseph Armbruster

Joseph Barnes

Joseph Taylor Jr

Joy Patrick

Joy Gombeda

Joy Banzon-Villamora

Joyce Walters

Joyce Tabios

Joyce Damiano

Juancho Trinidad

Juanita Jones

Judith Hochberger

Judy Ward-Bzoskie

Judy Araque

Julia Somerville-Reeser

Julia Olson

Julia Oleary

Julie Johnson

Julie Faulkner

Julie Bassett

Julie Fitzgerald

Julie Worman

Julie Kewanyama

Julius Caezar Henzon

K. Lynberg

Kaela Friedman

Kaitlyn Cummings

Kalita Silvestre

Karen Meskimen

Karen Eisenberg

Karen Lanham-Evans

Karen Bearer

Karen Valdez

Karen Laux

Karen Edwards

Karen Anne Wolfe

Karen Marie Beardsley

Kari Schleidt

Karisa Son

Karma Florence

Katelyne May Atijera

Katherine Kauble

Katherine Visman

Katherine Franco

Katherine Vernetti

Kathleen Mohn

Kathleen Zaski

Kathryn Schaller

Kathryn Moran

Kathryn Tickell

Kathy Webb

Kathy Goldsworthy

Katie Bomberger

Katie Green

Katrina Perkins Davis

Katylynn Hymas

Kayla Edwards

Kayla McMillen

Keiona Malone

Kelli Wray

Kelly Mecham

Kelly Bucalo

Kelly Sinkovec

Kelly Thompson

Kelly Morrow

Kelly Jane Villaroman

Keri Piper-Colonna

Killeen Bell

Kim Griffin

Kimberlee Bliek

Kimberly Falco

Kimberly Kandt

Kimberly Cathcart

Kimberly Simpson

Kimberly Maribbay

Kintana Wixom

Kirsten Landis

Kristen Grunerud

Kristie Meacham

Kristienne Porter

Kristin Hayden

Kristin Gillman

Kristina Spitale-Efstratis

Kristina Tischler

Kristine Coleman

Kristine Hafner

Kristyn Cisilino

Kylie Lewis

Lajuana Derico

Lanette Kimmel

Lara Carver

Lara Morales

Larissa Africa

Lashawna Franklin

Latricia Perry

Lattrice Dickson

Launa Curtis

Laura Harsh

Laura Martin

Laura Czajkowski

Lauren Tolentino

Laurice Jones

Laurie Walker

Lavon Elias-Jones

Layne Sellars

Lea Pauley

Leah Churchill

Leah Delim

Leah Gaitho

Lee Anna Bristol

Leidy Chavez-Guzman

Leigh Bohn

Leigh-Ann Biggs

Leila Cruz-Aguon

Leila Romero

Lenette Mapes

Leona Munro

Leslee Bridget Magnus

Leslie Decrona

Leslie Simmons

Leti Guerra-Scheib

Leticia Faust

Lia Harris

Linda Zahrt

Linda Bowman

Linda Silvestri

Linda Jacks

Linda Andrews

Linda Rittenburg

Linda Banks

Lindsey Butcher

Lindsey Enriquez

Lindsey Wharton

Linetta Barnes

Lisa Dinwiddie

Lisa Thomas

Lisa Eldridge-Murphy

Lisa Dunkelberg

Lisa Brown

Lisa Todd

Lisa Schaffer

Lisa Engleman

Lisa Marie Pacheco

Lloyzel Faye Yung

Lordlita Wirtz

Lori Roorda

Lori Eustis

Lori Baumann

Lori Marhanka

Lori Candela

Lorraine Noonan

Lorraine Bonaldi

Lorri Lantz

Luis Vidana

Luis Rodriguez

Luz Aragon

Lynn Licastro

Lynn Taylor

Lynn Von Schlieder

Ma Renzel Therezna

Caparros

Mackenzie Butler

Maddalena Fontein

Mae Nekoba

Maelaurece Plaza-Cross

Magdalena Rodriguez

Malcolm Aquino

Manasseh Chibwe

Maquette Thompson

Marcie Zajac

Marco Cerda

Marena Works

Margaret Louis

Margaret Calavan

Margaret Sanger

Margaret Covelli

Margo Baxter

Maria Elario


December 2020, January, February 2021 Nevada RNformation • Page 5

Maria Sampang

Maria Amezcua-Huerta

Maria Angela Nina Vela

Maria Concepcion

Benito-Spero

Maria Gina Agnir

Maria Mernina April

Montero

Maria Monica Aragon

Maria Nica Diez

Maria Rizel Sturgell

Maria Rosario Wood

Marian Gnandt

Maribel Gomez

Maribel Cabulang

Maricel Olan

Marie Luback-Neves

Marie Reyrao

Marie Snook

Marife Aczon-Armstrong

Marilyn Getty

Marisa Wilkinson

Marisa Leah Dela Rosa

Marisela Castorena

Marites Molina-Matro

Marizel Yukee

Marjorie Adams

Marjorie Von Nordeck

Mark Ferratt

Markeeta Araujo

Markita Griffin

Marlene Kramer

Marphyrose Galang

Marsha Park

Martha Hobby

Martha Drohobyczer

Mary Mackenzie

Mary Courtney

Mary Bondmass

Mary Field

Mary Manoharan

Mary Jingeleski

Mary Headley

Mary Whitield

Mary Huntly

Mary Flint

Mary McConville

Mary Reed

Mary Foster

Mary Denisse Toribio

Mary Grace Del Rosario

Maryangelique Sampson

Maureen Barnes

Maureen Nolen

Maureen Scott-Feagle

Mavirginia Espanol

Maya Washington

Maylene Culanag

Meg Hopper

Megan Remien

Megan Gates

Megan Gill

Megan Martinez

Meia Ford

Meilan Daguman

Melanie Lunghi

Melanie Lentz

Melba Schwinghamer

Melisa Smith

Melissa Ridella

Melissa Dorman-Ellis

Melissa Washabaugh

Melissa Cook

Melissa Rosales

Melody Talbott

Melody Tulloss

Mercedes Ocan

Merete Egloff

Merle Williams

Mi’Lan Jones

Michael McEvoy

Michael Bass

Michael Cabaccang

Michael Yazinka

Michael Loehr

Michael Basinger

Michael Cowles

Michele Rath

Michele Arce

Michele Wijangco

Michele (Shelly) Alfaro

Michelle Dunne

Michelle Bland

Michelle Dix

Michelle Tompkins

Michelle Albaran

Michelle Sarvela

Michelle Wagner

Michelle Podlesni

Michelle Reynolds

Mika Martin

Mindy Triola

Miriam Volpin

Mojisola Balogun

Mona Beerbower

Moneshia Perkins

Monica Ranada

Monika Asamaphand

Monty Gross

Myla Daigeau

Myra Davis-Alston

Myra Tomas

Nadia Luna

Nanci Quinn

Nancy Bartlett

Nancy Legaspina

Nancy Gubler

Nancy Brewster-Meredith

Naomi Lazore Edwards

Nasim Akbari

Natasha Tretheway

Nathan Fowler

Nathifa Charles

Nayeli Melendez

Nelly De Dios

Nemia Chiang

Ngozi Ajiri

Nicholas Muir

Nichole Fritel

Nicola Aaker

Nicole Caturay

Nicole Gooden

Nicole Courts

Nicole Carr

Nicole Hunt

Nicole Gregorio

Nicole Vaughn

Nicole Miskiewicz-Nelson

Nobuko Wallace

Nonette Chee

Noni Hayman

Norah Lusk

Norman Wright

Nubia Garbutt

Nutchar Ploymee

Odessa Gregorio

Ofelia Esguerra

Ogonnaya Onyema

Okechukwu Olisa

Olga Bienvenue

Oluyemisi Adedotun

Omana Olickal

Pamela Johnson

Pamela Adzima

Pamela Guerra

Pamela Burnley

Pamela French

Patrice Gallagher

Patricia Crepps

Patricia Fries

Patricia Strobehn

Patricia Prevosto

Patricia Busch

Patricia Brown

Patricia Alpert

Patricia Correll

Patricia Simmers

Patrick Bucayu

Paula Williams

Peggie Black

Peggy Ince

Peggy Lee

Peggy Kamper

Perla Labastida Espejel

Petal Codrington-Martial

Precious Achuff

Priscilla Nelson

Priscilla Austin

R Danessa Rebello

Rachel Likes

Rachel Juell

Rachel Michaels

Rachel Moore

Rachell Ekroos

Rachell Anne Agas

Ramona Chatman

Rannie Deguzman

Raquel Welsh

Rebecca Black

Rebecca Gansberg

Rebecca Roleff

Rebecca Pierce

Rebecca Graham

Rebecca Thomas

Rebecca Cormier

Rebecca Hayslett

Reginald Reyrao

Reina Alarcon

Remedios Jallorina

Renate Jeddahlyn Flores

Rene Wood

Renee Villarruel

Renee Page

Renee Hinojosa

Renee Todd

Rhea Bautista

Rhigel Tan

Rhonda Strunk

Rica Martin

Rica Santa Maria

Rich Janel Suanes

Richard Becker

Rita Siu

Rizza Marie Tawatao

Robert Lopez

Robert Welch

Robert Fox

Robert Erickson

Robert Briseno

Robin Hoover

Robin Branham

Roderick Gipson

Roger Patricio

Roland Villareal

Rona Yee

Rona Divinagracia

Ronnie Bordador

Rosalba Renteria

Rosalyne Reynolds

Roscelle Jhoyce Minoza

Rose Hettinga

Roseann Colosimo

Rosemary Witt

Rosemary Gharibian

Rosemary Thuet

Roshele Ward

Rowena Mananquil

Rowena Dioquino

Ruth Politi

Sabina Grimes

Sabrina Bratcher

Sally Jost

Sally Adams

Samantha Jones

Samantha Thornton

Samantha Chanel De

Vera

Samantha-Rose Threats

Sandra Turner

Sandra Rodriguez

Sandra Talley

Sandra Doolin

Sandra Pierre-Louis

Sara Maul

Sara McKnight

Sarah Moore

Sarah Linaman

Sarah Johnson

Sarah Webb

Sarah Herbert

Sarah McCalden

Sarah Maciolek

Sarah Bussmann

Sarah Rose Nelson

Saundra Hart

Savalla McLeod

Schlene Peet

Selina Rivera

Shaheen Ahmad

Shana Blakely

Shannon Murray

Shannon Grella

Shannon Chartrey

Sharean Oxley

Sharon Freier

Sharon Szeman

Sharon Mann

Sharon Attaway-Hett

Sharon Oetting

Shasta Taylor

Shaun Hasty

Shaunta Brown

Shawn Deal

Shawn Joseph

Shawna Senart

Sheery Villagracia

Sheila Parker

Sheimon Capiendo

Shelby Temple

Shelia Bien

Shelly Nicola

Shelly Soto

Sheri Park

Shermeka Tubbs

Sheron Williams-Nevens

Sherri Lindsey

Sherri Yagoubi

Sherri Howell

Sherrian Miles

Sherrie Olson

Sherry Stofko

Sheryl Bennett

Shirin Nazarian

Shirley Caldwell-Butts

Skyler Basanez

Sonia Wyatt-Wright

Loneliness and Social Isolation

Cause Emotional Pain in the Elderly

Sonja Poppenhagen

Sonja Mann

Sophia Student

Sorah Chung

Stacey Earley

Stacey Hunt

Stacey Lea Spahn

Staci Thompson

Stacy Springgate

Stacy Rust

Stacy Thaler

Stacy Wilson

Stacy Demitropoulos

Starla Ricks

Stefny Cabrera

Stephanie Latta

Stephanie Parker-Hyman

Stephanie Prather

Stephanie Crim

Stephanie Curry

Stephanie Herrera

Stephanie Guerrero

Stephanie Melcher

Stephanie Neder

Stephen Lester

Steven Knott

Susan Hubbard

Susan Becker

Susan VanBeuge

Susan Growe

Susan Ervin

Susan Englen

Suzann Gordon

Suzanne Dessaints

Suzanne Elnagar

Sylvia Fernandez

Tabbly Taylor

Tamara Duff

Tamara Mette

Tamasha Benson

Tamera Allred

Tami Beckett

Tammam Whalen

Tammy Bambic

Taneya Wills

Tanya Liscio

Tara Alcid

Tendai Gombe-Lane

Teresa Mercado

Teresa Praus

Terri Vinson

Terry Stanley

Thelma Pacheco

Theophilus Akoh

Theresa Gordon

Theresa Spina

Theresa Brown

Theresa Carr

Therese Rohling

Tiffani Lenzi

Tiffany Febre

Tiffany Ramirez

Tiffany Vincent

Tiffany Yohey

Tiffiny Cicero

Tina Procter

Todd D'Braunstein

Todd Erickson

Todd Isbell

Tomas Walker

Toni Orr

Tonya Bryant

Tori Davis

Toya Lewis

Tracey McCollum

Tracey Silva

Tracey Johnson-Glover

Tracie Gust

Tracy Harig

Trevelyn Gray

Trina Hammond

Trinette Broom

Tristen Wydeman

Trixia Mora

Tymeeka Davis

Tysha Jones

Valan Kam

Valeria Melendez Estrada

Valerie Jakubos

Valerie Castaneda

Vanessa Obando

Vanessa Parker

Vanessa Izquierdo

Vera Sverdlovsky

Veronica Dunn-Jones

Veronica Brady

Veronica Niki James

Vicki Walker

Vicki Wolms

Vickie McPherson

Vicky Lang-Catlin

Victoria Volz

Virginia Enns

Virginia Williamson

Virginia Hayes

Visminda Tagbo

Vivian Smith

Wanda Sheppard

Wanda Macfarlane

Wanesa Yuhmo

William Macaraig-Organ

Winnie Chua

Xandee Shirley Bernabe

Xenia Daffodil Valles

Yarleny Roa-Dugan

Yashmine Ballesteros

Yvette Medlin

Yvonne Anderson

Yvonne Modarres

Zachary Bunker

Zachary Ashton

Zhuoya Mai

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?

Loneliness and Social Isolation...continued on page 12


Page 6 • Nevada RNformation December 2020, January, February 2021

Research & EBP Corner

Tranquility Rooms and Stress Reduction

Submitted by

Mary Bondmass, Ph.D., RN, CNE

This RNF feature presents abstracts of research and

evidence-based practice (EBP) projects completed or

spearheaded by nurses or student nurses in Nevada.

The focus is on new evidence (i.e., research) or on the

translation of evidence (i.e., EBP) in Practice, Education,

or Research. Submissions are welcome and will be

reviewed by the RNF editorial board for publication;

send your abstract submission in a similar format used

below to mary.bondmass@unlv.edu

Michelle McGrorey, BSN, RN, OCN, HTCP, NCCA,

HNB-BC, HMIP and Deborah McKinney, BSN, RN, HMIP

took first place honors at the recent 3rd Annual UMC

Research Empowerment Day in the Completed Clinical

Project Category. Michelle and Debbie’s research

focused on the use of Tranquility Rooms to reduce staff

stress at University Medical Center of Southern Nevada.

Their picture, abstract and poster are below.

Michelle McGrorey, BSN, RN, OCN, HTCP, NCCA,

HNB-BC, HMIP and

Deborah McKinney, BSN, RN, HMIP

Background:

Jobs in the healthcare industry are among the most

stressful in the U.S. Work hours, burn-out, compassion

fatigue, overtime, and conflict make self-care difficult.

Lack of self-care can render any health care worker

ineffective on the job. In a hospital setting, quiet rooms

are playing a critical role in mitigating severe and/or

overwhelming stress often experienced by staff during

shifts that exhaust emotional and mental reserves.

Quiet rooms have been shown to promote well-being

and resiliency. UMC has created Tranquility Rooms for

staff as safe spaces where they can relax, calm, and

de-stress for a time. It is hoped that staff will regain

necessary emotional, mental, and physical resiliency,

thereby restoring work effectiveness.

Purpose:

To explore the feasibility of maintaining the

Tranquility Rooms permanently, and possibly creating

more rooms, UMC’s Tranquility Rooms were evaluated

for their effectiveness in reducing stress experienced by

staff.

Methods:

Each Tranquility Room is decorated as a home-like

room, offering the C.A.R.E. Channel, an essential oil

diffuser, ambient lighting, a comfortable recliner, and

several modalities known for their calming effects. The

sample included 132 staff, from December 2019 to

September 2020, who voluntarily completed 10-point

Likert scales to measure perceived stress before versus

after using the Tranquility Rooms.

Results and Conclusion:

The Tranquility Rooms demonstrated significant

reduction in employee stress while on-the-job. The

rooms were used throughout all work shifts. Staff

stated the rooms reduced stress and helped them

perform more effectively. Pre-tranquility room use

stress scores were 6.83 compared to 2.43 after

use of the tranquility room (p = < 0.05). Staff have

commented they do not want it known how often

they are using the rooms. Staff are asking for more

Tranquility Rooms and because of the positive

response, UMC is looking for ways to create more

Tranquility Rooms throughout the hospital. Additional

Tranquility Rooms would reduce travel time required

for busy staff. Some staff have even taken it upon

themselves to create Tranquility Rooms within their

own departments.

Implication for Practice:

According to JAMA, hospitals with better nursing

work environments for nurses provided better quality

patient care.


December 2020, January, February 2021 Nevada RNformation • Page 7

Taking Time for Self-Care during COVID

By Michelle McGrorey BSN, RN, HTCP, HBN-BC, OCN, HMIP, NCCA and

Vicki Walker DNP, BS, RN

During this time of pandemic practicing nurses are faced with extreme stress

both at home and work. Now more than ever is the time to pause and appraise

your routine for self-care. Practices like mindfulness, aromatherapy, meditation, etc.

may be familiar to you or you may be a novice just exploring what is out there. To

advance your learning here are a few tips for aromatherapy practices.

Today there is an abundance of products for aroma therapy, but consumer

beware, many products on the market are not pure essential oils and you may not

experience the expected biological effects without ensuring product quality. The

essential oil effects that we are suggesting in this article are based on pure plant oil

extracts. We do recommend if you are unfamiliar with product selection that you

seek further guidance from experts.

Here are some simple guidelines:

Lavender -

(Lavandula

angustifolia)

Cedarwood -

(Juniperus

virginiana)

Vetiver -

(Vetiveria

zizaniodes)

Oils to Support Relaxation

Oil Primary Effects Uses Techniques for

Use*

Bergamot -

(Citrus bergamia)

Roman

chamomile -

(Chamaemelum

Nobile)

Cinnamon -

(Cinnamomum

zeylanicum)

Clove -

(Eugenia

caryophyllata)

Eucalyptus -

(Eucalyptus

globulus)

Relaxation, airborne

antimicrobial, antiinflammatory

Antibacterial, CNS

sedating, antiinflammatory

CNS sedating,

immunostimulant,

Anti-inflammatory

Anti-inflammatory,

antispasmodic,

antibacterial

Analgesic, antispasmodic,

antiinflammatory

Sleep support

Calming

Stress reduction

Calming

Respiratory

support

Stress reduction

Sleep support

Relaxation Mood

support

Support emotional

health

Respiratory

support

Stress reduction

Sleep support

Pain support

Muscle relaxation

Oils to Support Immunity

Inhalation

Topical

Inhalation

Topical

Inhalation

Topical

Inhalation

Topical

Safety – can be

phototoxic

Inhalation

Topical

Oil Primary Effects Uses Techniques for

Use*

Frankincense -

(Boswellia carterii)

Lemon -

(Citrus limon)

Anti-inflammatory,

antibacterial,

antioxidant,

immunomodulatory

Analgesic, antiinflammatory,

anti-bacterial, antiviral,

anti-fungal,

immunostimulant

Anti-inflammatory,

analgesic, antibacterial,

airborne

anti-microbial

Anti-inflammatory,

antibacterial,

antifungal

Anti-inflammatory,

antibacterial,

antioxidant

Immune support,

Great for diffusing

as an air purifier

Stress reduction

Great to use for

natural cleaning

Immune support

Pain support

Mood support

Respiratory

support

Immune support

Use for natural

cleaning

Emotional support

Immune support

Mood support

Immune support

Use in natural

cleaning

Inhalation, room

spray, cleaning

Safety – heavily

dilute before use;

not for children

< 10

Inhalation

Topical: only if

heavily diluted

Safety: avoid

with severe

renal disease;

avoid in young

children; may have

anticoagulant

properties; heavily

dilute before use

Inhalation

Topical

Safety – avoid

in babies and

children


Page 8 • Nevada RNformation December 2020, January, February 2021

NNA Environmental Health Committee

Environmental Health and Homelessness

Shelter is a basic necessity that many of us take for

granted. Since prehistoric times, humans have been

building structures to protect themselves from the

elements. The good fortune to wake up in a warm

bed, turn on the faucet for water, open our refrigerator

for food, and have access to a shower are all modern

conveniences that are commonplace for the majority

of the population. Without a home, it is difficult for

individuals and families to achieve stability, personal

hygiene, obtain employment, receive an education, or

receive necessary health services. People experiencing

homelessness are at an increased risk of premature

death, have higher rates of chronic health conditions,

including mental illness and substance abuse, and use

emergency services more frequently (Maness & Khan,

2014). In the last decade, homeless encampments

have been on the rise, due to the lack of affordable

housing and absence of a living wage (National Law

Center on Homelessness and Poverty, 2017). At the

bedside and in the community, nurses observe in their

patients the importance of shelter and the associated

health impacts of living on the streets on a daily basis.

This article offers a perspective on the challenges of

people experiencing homelessness and the associated

environmental health-related issues.

Environmental Health and Vulnerable populations

It is common knowledge that collective human

actions have negative impacts on our environment

and human health. An estimated 12.6 million people

die every year as a result of avoidable environmental

health risks such as climate change and environmental

degradation (World Health Organization, 2020).

Vulnerable populations such as those experiencing

homelessness are disproportionately affected

by environmental degradation and often lack

representation in environmental regulation and policy.

This same population has a higher risk of disease

processes associated with environmental hazards

(Ramin & Svoboda, 2009).

The COVID-19 Pandemic

History has shown that large-scale outbreaks of

infectious disease present challenges to everyone,

especially the most vulnerable members of the

population. The COVID-19 pandemic has exacerbated

health disparities experienced by the homeless

population and limited their access to available

resources. People experiencing homelessness have

a higher risk of contracting COVID-19 and are

differentially burdened by the impacts of the pandemic

(Karaye & Horney, 2020). Persons experiencing

homelessness who had health risks prior to the

pandemic, now have new barriers to accessing income,

resources, and healthcare.

The pandemic has had a special impact on the

homeless population here in Nevada. Representatives

from various shelters across the state of Nevada have

reported that many shelters had to either reduce

capacity, place a temporary hold on accepting new

clients, or shut down temporary shelters completely as

a result of the pandemic.

Environmental Injuries Related to Homelessness

People who are homeless endure various

environmental injuries as a result of extreme weather

conditions, climate change impacts, and simply living

outside without shelter (Ramin & Svoboda, 2009).

Health becomes a low priority for homeless individuals

who are struggling to meet their basic needs (Koh &

O’Connell, 2016). In interviews with Terry Lindeman,

Director of Family Promise in Las Vegas and Emma

Neville, program manager at Tahoe Coalition for the

Homeless (TCH), it is evident that environmental health

conditions are dependent on the climate of a particular

region, as there is high variability in temperature and

terrain across the state of Nevada.

The homeless population in the Tahoe area suffer

from cold-related illnesses such as hypothermia,

frostbite, and acute exacerbations of chronic respiratory

diseases related to wildfires and high altitude. Whereas,

the homeless population in Las Vegas suffer from heatrelated

injuries such as sunburns, pavement burns,

heat exhaustion, and heat stroke. Both regions see

incidences of dehydration, bug bites, and improper

wound healing due to poor hygiene and unsanitary

living conditions. When caring for a patient who is

experiencing homelessness, it is important for nurses

to include assessments for these conditions and expand

their focus beyond the major presenting complaint.

Hearing a first-hand experience of being homeless

can be a powerful reminder of the many challenges

faced by this population. One of the Tahoe Coalition

for the Homeless clients I spoke with told me her

story, “one time I woke up in the hospital wrapped in

warming blankets and the doctors told me my body

temperature had reached 80 degrees; that was the

night my sister wouldn’t let me into her house and I fell

asleep outside without a sleeping bag” (Anonymous

homeless client, personal communication, October 21,

2020).

The Homeless Population in Nevada

According to recent statistics, there are currently

7,169 homeless residents in Nevada which includes

families, young adults, and veterans. Of those

people, 727 on average are unsheltered at night (U.S.

Interagency Council on Homelessness, 2019). As of

2019, there are roughly 567,715 people in the United

States who are experiencing homelessness (National

Alliance to End Homelessness, 2020). It is difficult to

find current statistics on homelessness following the

COVID-19 pandemic.

As it stands, there are not enough resources

in Nevada to fulfill the needs of everyone who

experiences homelessness. Nevada requires more viable

solutions to this growing problem, as there are still

hundreds of Nevadans without shelter on any given

night. The recommendations from the CDC for people

experiencing homelessness is to continue placing

them in temporary stable housing as a priority and

allow those who are living in encampments to remain

where they are (CDC, 2020). Yet, people experiencing

homelessness continue to be displaced from these

encampments without guaranteed housing placement.

Homeless Encampments and Environmental Impacts

All human beings have an impact on the

environment with daily living. Homeless encampments

along the Truckee River in both Reno and Tahoe

have detrimental impacts to this natural habitat and

essential water source. Trash, human waste, and

hypodermic needles litter the river banks and put these

communities at risk. Recently, during the pandemic,

the city of Reno has ramped up efforts to clean up this

area due to environmental threats and fire hazards,

and are displacing homeless people in the process

(Conrad, 2020). However, these types of initiatives

are not getting to the root of the problem, which is

providing a permanent housing solution for people

who are homeless to protect their health, the health

of the public, and the natural environment. Many

people experiencing homelessness simply don’t know

what to do with their waste; anonymous clients of the

Tahoe Coalition for the homeless reported that there

are no public areas to take trash without incurring

illegal dumping fees, bears are frequently encroaching

on their encampments, and there is a lack of public

bathrooms.

Solutions

Housing is the obvious solution to ending

homelessness and the associated negative health

outcomes and environmental impacts. There are

encouraging examples of projects that have been

successful in reducing homelessness. In the United

States, there are 80 communities and three states

that have ended veteran homelessness and four

communities that have ended chronic and veteran

homelessness; this means they have established

systems to ensure that homelessness is rare, brief,

and a one-time occurrence (United States Interagency

Council on Homelessness, 2019). One of the silver

linings of this pandemic is the public health response

from the federal government. The Coronavirus Aid,

Relief, and Economic Security (CARES) Act was passed

by Congress March 27th, 2020 and has distributed

over $2 trillion in economic relief packages to local

communities across the country to protect people from

the public health and economic impacts of COVID-19

(U.S. Department of Treasury, n.d.).

Emma Neville of the Tahoe Coalition for the

Homeless (TCH) received funding from project

Roomkey, a California state program that enables

Encampments of the Homeless

Photos courtesy of the Tahoe Coalition for the Homeless, taken by Ryan Hunt


December 2020, January, February 2021 Nevada RNformation • Page 9

NNA Environmental Health Committee

people experiencing homelessness to shelter in place

through temporary housing. One of the goals with

these new projects is to reduce emergency visits

related to environmental injuries through housing

and preventative care services. “One of the best

things I hear with this job is, thank you for saving my

life” (Personal communication with Emma Neville,

November 10, 2020).

Terry Lindemann of Family Promise of Las Vegas

reports that housing first is the most important answer

to ending homelessness, and reports that collaboration

between nonprofit organizations in Southern Nevada

has been key to helping people in the community who

are homeless, as she says, “it is not going to be one of

us, it is going to be all of us” (Personal Communication,

Terry Lindeman, November 12, 2020).

A Success Story

Terry Lindeman recalls a successful story of one of

the families who was helped through Family Promise

of Las Vegas: “A story I remember well, was a single

mother who was discharged from the hospital with

chronic kidney disease and during her hospitalization

she had lost her job and her apartment. We were

able to place her and her family in housing and pay

her vehicle insurance in order for her to get to her

daily dialysis appointments. From there, we continued

to work with this family in order to achieve their

goals of returning to work, getting back into their

own apartment, and helped them to remain selfsufficient.

This family would have faced insurmountable

challenges without the assistance of our nonprofit

and today they are housed and doing well and they

have been able to overcome all of their challenges”.

(Personal communication with Terry Lindeman,

November 12, 2020).

The Nurse’s Role: Care & Compassion

Nurses have a responsibility at the bedside and

within their communities to help people experiencing

homelessness to improve their health through

education, outreach, and referral to appropriate

resources. These nurse-led interventions increase

participation in public health programs, prevent risky

health behaviors, and improve health outcomes

(Weber, 2019). Nurses also have an obligation to

advocate for policies that aim to reduce homelessness,

climate change, and environmental degradation. The

nurse’s ability to uphold equity and respect when

caring for people experiencing homelessness is crucial

to establishing a trusting relationship with the patient

and helping guide them toward available resources.

In a recent survey conducted by TCH, clients were

asked “what is the hardest thing you face as a result

of being homeless,” and the overwhelming response

was “I don’t feel like I’m treated like a human being

anymore,” one individual stated, “people don’t want

to look me in the eye.” Homelessness is a traumatic

experience and it is imperative that nurses move

beyond judgment and lead with compassion. At the

core of our profession is caring!

Authors

References

Centers for Disease Control and Prevention (2020,

September 16). Retrieved October 22, 2020, from

https://www.cdc.gov/coronavirus/2019-ncov/

community/homeless-shelters/faqs.html

Conrad, B. (2020, September 24). City to ramp up homeless

camp cleanups, enforce no camping ordinances. This is

Reno. Retrieved from https://thisisreno.com/2020/09/

city-to-ramp-up-homeless-camp-cleanups-enforce-nocamping-ordinances/

Karaye, I. M., & Horney, J. A. (2020). The impact of social

vulnerability on COVID-19 in the U.S.: An analysis of

spatially varying relationships. American Journal of

Preventive Medicine, 59(3), 317–325. doi: 10.1016/j.

amepre.2020.06.006

Koh, H. K., O, C. J. J., & O’Connell, J. J. (2016). Improving

Health Care for Homeless People. JAMA: Journal of

the American Medical Association, 316(24), 2586–

2587. https://doi-org.unr.idm.oclc.org/10.1001/

jama.2016.18760

Maness D. L., Khan, M. (2014) Care of the homeless: an

overview. American Family Physician, 89(8), 634-40.

National Alliance to End Homelessness. (2020). State of

Homelessness: 2020 Edition. Retrieved from https://

endhomelessness.org/homelessness-in-america/

homelessness-statistics/state-of-homelessness-2020/

Shelters and Resources for People Experiencing Homelessness in Nevada

Adult Services

Volunteers of America, Northern Nevada -

Reno

website: www.voa-ncnn.org/northern-nevada

phone: (775) 329-4141

address: 335 Record St., Reno, NV 89512

Reno-Sparks Gospel Mission

website: www.rsgm.org

phone: (775) 323-0386

Friends in Service Helping - Carson City

website: www.nvfish.com

phone: (775) 882 – 3474

address: 138 E Long St, Carson City, NV 89706

Tahoe Coalition for the Homeless - Tahoe

website: www.tahoehomeless.org

phone: (530) 600-2822

address: PO Box 13514, South Lake Tahoe, CA,

96151

Friends in Service Helping - Elko

website: www.fishelko.org

address: 487 South 5th Street, Elko, NV 89801

phone: (775) 738-7800

Las Vegas Rescue Mission

website: www.vegasrescue.org

phone: (702) 382-1766

address: 480 West Bonanza Rd, Las Vegas, NV

89106-3227

Family Promise of Las Vegas

website: www.familypromiselv.com

phone: (702) 638-8806

address: 1410 S. Maryland Pkwy., Las Vegas, NV

89104

National Law Center on Homelessness and Poverty. (2017).

Tent city, USA: the growth of America’s homeless

encampments and how communities are responding

[pdf]. Retrieved from https://nlchp.org/wp-content/

uploads/2018/10/Tent_City_USA_2017.pdf

Ramin, B., & Svoboda, T. (2009). Health of the homeless

and climate change. Journal of Urban Health: Bulletin

of the New York Academy of Medicine, 86(4), 654–

664. https://doi.org/10.1007/s11524-009-9354-7

United States Department of Treasury (n.d.) The CARES act

works for all Americans. Retrieved November, 14 from

https://home.treasury.gov/policy-issues/cares

United States Interagency Council on Homelessness (2019).

Nevada Homeless Statistics. Retrieved on October 20,

2020, from https://www.usich.gov/homelessnessstatistics/nv/

United States Interagency Council on Homelessness (2019).

Communities that have ended homelessness. Retrieved

October 20, 2020 from https://www.usich.gov/

communities-that-have-ended-homelessness/

Weber, J. J. (2019). A systematic review of nurse led

interventions with populations experiencing

homelessness. Public Health Nursing, 36(1), 96–106.

https://doi-org.unr.idm.oclc.org/10.1111/phn.12552

World Health Organization. Climate change and human

health. Retrieved November 11, from https://www.

who.int/globalchange/mediacentre/news/cop23-23-

key-messages/en/

Youth Services

Eddy House - Reno

website: www.eddyhouse.org

phone: (775) 384-1129

address: 888 Willow St., Reno, NV 89502

Shannon West Homeless Youth Center

website: www.helpsonv.org

phone: (702) 369-4357

address: 1650 E. Flamingo Rd. Las Vegas, NV 89119

Nevada Partnership for Homeless Youth

website: www.nphy.org

phone: (702) 383-1332

address: 4981 Shirley St, Las Vegas, NV 89119

Additional Resources

HopeLink of Southern Nevada

website: www.link2hope.org

phone: (702) 566-0576

address: 178 Westminster Way, Henderson, NV

89015

Nevada 211 of the Nevada Department of

Health and Human Services

website: www.nevada211.org/shelter

phone: 211

City of Reno: Homeless Resource Page

www.reno.gov/government/departments/

community-development/housing-homelessresources/homeless-resources

Nevada Homeless Alliance

website: www.nevadahomelessalliance.org

Help Hope Home

https: www.helphopehome.org

Tihisha Vaccaiah, RN

The Orvis School of

Nursing

University of Nevada

Reno

Bernadette M. Longo,

Ph.D., RN, APHN-BC,

CNL, FAAN

Chair, NNA’s

Environmental Health

Committee

Associate Professor

Emerita, Orvis School

of Nursing

January 2021

NATIONAL RADON

ACTION MONTH

Get a free radon test kit!

Jan. 1 thru Feb. 28

call the Nevada Radon Hotline

888-RADON10 (888-723-6610)

All Nevada homes should be tested for radon!


Page 10 • Nevada RNformation December 2020, January, February 2021

Antimicrobial Stewardship – Infection Prevention

SARS-CoV-2 and Infection Prevention - Stop the Bleed

By Norman Wright, RN, BSN, MS – Infection Preventionist

It is Thanksgiving Day 2020. SARS-CoV-2 (Coronavirus)

infections and Covid-19 hospitalizations are surging for the

third time this year, and the wave is building with no crest

in sight. During the first wave back in April 2020, Nevada’s

highest seven-day running average of SARS-CoV-2 infections

was only 161. The second wave peaked on July 20, 2020,

when the 7-day average of daily infections increased to

1,171.

We are now experiencing the third wave, and it is hitting

hard. We have blown past last summer’s numbers, and on

November 26, 2020, Nevada’s 7-day average of infections

more than doubled to 2,415.

Before the election, people attended packed campaign rallies, many without

masks, and street demonstrations continue. CDC’s recommendations are ignored,

and people crowd into airports traveling to spend Thanksgiving with family.

Continuing to disregard basic infection prevention guidelines will result in infections,

hospitalizations, and deaths, to increase astronomically.

Graph #1 Nevada’s Daily Infections

https://www.worldometers.info/coronavirus/usa/nevada/

Graph #2 Nevada’s Hospitalizations

https://covidtracking.com/data/state/nevada/hospitalization

It is Thanksgiving, and to date, 2,092 Nevadans have died. Yes, treatment options

are improved, and the percentage of deaths vs. the number of infections has

decreased; the only problem, infection rates are skyrocketing.

I pray I am wrong, but I fear deaths will increase at a blistering pace in the

coming months. The Institute of Health Metrics (IHME) latest estimate is that by

February 2021, Nevada’s death toll will be over 3,700. The unfortunate reality,

deaths peak about a month after the number of infections begins to decrease, and

Nevada's daily infection numbers continue to escalate.

At NNA’s 2019 annual convention, a “STOP The BLEED” educational session

was taught. Without going into details, the most important takeaway was, “When

someone is bleeding, do something, anything, to stop the bleeding." Tear off

your sweaty shirt or your belt, use anything at all that can compress, or acts as a

tourniquet, to stop a person from bleeding out.

That said, an infection prevention article telling you to press an unsanitary towel

or to tie your shoelace above an open wound seems to be a non sequitur, but it

is not. First Aid Basics are ABC (Airway, Breathing, Circulation). Bottom line, if

the person dies from bleed out before getting to the hospital, infection prevention

recommendations and antimicrobials are of no concern nor useful.

https://www.cdc.gov/coronavirus/2019-ncov/covid-data/forecasting-us.html

When someone is bleeding out, immediate action must be taken, or death

quickly occurs. Yesterday's 7-day average of SARS-CoV-2 deaths in the United States

was 1,708, and the CDC estimates that the numbers will increase.

September 11, 2001, when 2996 Americans died after four hijacked airplanes

crashed into the World Trade Center, the Pentagon, and a field in Pennsylvania - is a

date burned into my memory – and now, every two days, more Americans die from

COVID-19 than died on 9/11 - think about that for a minute.

The daily tally of COVID-19 deaths has continued for so long that many have

become numb to the reality and are experiencing “COVID Fatigue." Some of us, too

many, refuse to wear masks, shelter in place, or take other necessary precautions.

Despite the increase in hospitalizations and deaths, mixed messaging has caused

confusion. Some still don’t believe SARS-CoV-2 is real, while others are letting their

guard down.

Media emphasis has been on a "cure," not prevention. Ineffective remedies such

as hydrochlorothiazide were hyped, and mitigation efforts were minimized, even

discounted. The result, infections are spreading like wildfire.

Vaccine development has been politicized and hyped for months. Vaccines

are now in the process of being approved, and indications are, before the New

Year, there will be at least two different vaccines available, some claiming a 95%

immune response. Hopefully, by February 2021, we will be vaccinating health

care professionals, first responders, vulnerable senior citizens, and others with comorbidities.

But it will take many more months before a large percentage of our

population can be vaccinated.

The term “Herd Immunity” is being discussed in the media as a way out of

our dilemma, but between 70 to 90 percent of our population must be infected

or vaccinated before “Herd Immunity” is achieved, and this probably will not occur

until early summer, if at all.

A problem with “Herd Immunity Theory” is that immunity to Coronavirus may

not last long. Unlike smallpox and polio vaccines, SARS-CoV-2 immunity may last

only a year or less. (1) (2) (3) (4)

The trajectory of how quickly Coronavirus infections spread is frightening,

and this is where the analogy of comparing the "slow-motion pandemic" we are

experiencing is equated with the quick action that must be taken to preserve a life

when witnessing someone bleeding after a car accident, or a mass shooting. — (See

accompanying article Stop the Bleed Training).

SARS-CoV-2 is a novel virus that spreads rapidly. Every day we learn more

about it, and older data that is less accurate gets mixed in. Since last January, we

have been fed a constant barrage of information and misinformation regarding

COVID-19. It is on TV, in newspapers, the Internet, Twitter, and various other media

sources.

Masks help to stop spreading infection from the wearer to others, and masks also

protect the wearer from being infected, but wearing a mask has become politicized.

Many media sources continue to spread doubt, causing confusion and noncompliance.

The result, the number of infections is soaring into the stratosphere. (5)

Basic infection prevention practices, wearing a mask, social distancing, hand

hygiene, and doing other preventative measures is how we stop the slow bleed of

hospitalizations and deaths from COVID-19, and this is where the analogy of saving

the life of someone who is bleeding out differs from the unified approach that must

be taken to stop the spread of the infection.

Mitigation requires buy-in from society as a whole, and if we fail, tens of

thousands more will unnecessarily die.

But viewing the pandemic only in terms of the number of hospitalizations

or deaths is shortsighted. Ignoring the societal, economic, and psychological

impacts, many recovering from a SARS-CoV-2 infection, even those who were not

hospitalized, have a different form of "COVID fatigue," which is one of the many

post-infection symptoms that “Long Haulers” have. (6)

Today is Thanksgiving, and 2020 is a year we will all remember. Let’s be thankful

for all we have because looking at what is lost only creates negativity that generates

a downward spiral.

After the October 1 Las Vegas shooting occurred, the term “Vegas Strong”

resounded, and we recovered. It is time for us to work together, and when we do,

Nevada Strong, indeed USA Strong, will echo around the world.

Ultimately the actions we take today determine our future. Not just your future,

but a future that our children and their grandchildren hopefully will enjoy. Ultimately

infection prevention is an individual responsibility that everyone must practice. If we

don't deal with COVID-19 locally, it is impossible to control it anywhere.

Onward to 2021 – and the future!

Citations:

(1) https://www.niaid.nih.gov/research/immune-response-covid-19

(2) https://www.cdc.gov/coronavirus/2019-ncov/hcp/faq.html#COVID-19-Risk

(3) https://www.mayoclinic.org/diseases-conditions/coronavirus/in-depth/herd-immunityand-coronavirus/art-20486808

(4) https://apic.org/monthly_alerts/herd-immunity/

(5) https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/cloth-face-coverguidance.html

(6) https://www.mayoclinic.org/coronavirus-long-term-effects/art-20490351


December 2020, January, February 2021 Nevada RNformation • Page 11

Healthy Nurses

By Tracey Long PhD, APRN-BC, CDE, CNE, CCRN

Nurses educate patients

about the value to get vaccines

all the time, but how many

nurses actually get those same

vaccines for themselves? The

annual influenza vaccination

is often a requirement for

healthcare professionals to

reduce absenteeism and

reduce influenza-related

morbidity and mortality,

however only approximately

78% of health care personnel actually comply with

the recommendations for themselves (CDC, 2018).

Coverage was lowest among nurses working in longterm

care settings. According to a qualitative study,

the reasons why nurses decline influenza vaccination

included mistrust of safety, overuse of vaccinations

and even rebellion over being told what to put in their

own body and wanted decisional autonomy (Pless et al.

2017). And yes, nurses do have a right, just like anyone,

to choose.

However, nurses hold a responsibility to deliver

complete and objective information when providing

patient education. Research proves a nurse’s opinion

sways the advice they give patients and vaccinated

nurses are more inclined to recommend vaccination

than those who are unvaccinated (Smith et al, 2016).

Interestingly, the more highly educated the nurse is, the

higher the incidence they will be vaccinated.

Just as each nurse has unique values and beliefs,

each healthcare professional is an individual who

may decide their position about personal vaccination.

It is also true that nurses may deliver a healthcare

intervention they do not believe in, yet still administer

the care or medication the Provider orders. Regardless

of which side you take, every nurse has the right

to choose for themselves their habits of health and

balance that with their nursing duties.

We also have seen polar opposite opinions from

nurses during the COVID-19 worldwide pandemic

and face mask use in the past nine months. With the

production of hoped-for vaccines against COVID-19,

nurses will be asked by friends, family and colleagues

what to do. Regardless of a nurse’s personal or

political opinion, current health counsel against

COVID-19 should still be given by nurses and includes

the following based on the CDC guidelines: wash

hands frequently with soap and water or any alcoholbased

sanitizer, dispose of used tissues and masks

into a plastic-lined waste bin instantly, use a tissue

to cover your mouth and nose while coughing or

sneezing, don’t touch your mouth, eyes, or nose,

avoid close contact with any individual having cold or

flu-like symptoms, clean surfaces often, avoid sharing

utensils, food, or drinks, avoid crowded places and

stand six feet apart from others. If you are unwell, seek

medical attention immediately, stay at home and avoid

contacting others.

There is no doubt that despite adherence to the

CDC guidelines, people are still getting sick and nurses

are exhausted. The media reports higher anxiety,

suicide and depression in America in 2020 because

of the long-term consequences of COVID-19 and

social distancing. As people rely on the opinion and

education of nurses, we can make a difference in the

possibly worse virus the world is experiencing- fear and

depression.

Beyond the prudent CDC guidelines against

COVID-19, the next level of patient education for

health care guidelines for mental health may include

the following for yourself and those you educate:

Media Distancing

If media is creating or worsening your anxiety, stop

consuming it. Distance yourself from the negativity

of media and fear (ADAA, 2020). You can still stay

informed by catching major headlines on an occasional

review of weekly highlights, but you don’t have to

bombard yourself with the plethora of negativity and

focus on racism, hatred, crime and distress most news

cycles focus on.

Take Control of Your Thoughts

The more your mind focuses on worst-case

scenarios, the more anxious you will feel. Rather than

allowing the very normal negative and fearful thoughts

that pass through your brain to stay and destroy your

energy, take action into problem solving. Much of

anxiety and stress comes from fear of the unknown

and lack of control. Rather than allowing your mind to

entertain doomsday thoughts, be proactive and focus

your thoughts on actions you can take that are in your

control. Proactive action towards your own goals is a

great way to crush pessimism.

Focus on Being Productive and New Ways of

Enjoying Life

Although you cannot control a worldwide

pandemic or political crisis, you do have control

over your response to the crisis. Among the many

humorous posts on social media was the comparison

of two women who each announced, “I’m using

this quarantine time to better myself by developing

a new skill at home,” while the other quipped “I just

ate carrot cake with my bare hands.” Life isn’t what

happens to you, but rather how you choose to respond

to it. A good sense of humor helps a lot. Pass the carrot

cake. Fork is optional.

Engage in Stress Reducing Activities

Train your mind to manage stress by employing a

variety of strategies including focusing on gratitude,

exercising your body, guided meditation, yoga, writing

gratitude notes and more, which can lower stress.

Find something new you’ve been wanting to do

but could never find the time to learn or do. Life will

never be stress-free, but your actions can help make it

manageable and not destructive.

Do Not Go Beyond CDC Guidelines

Nurses can help decrease the anxiety and stress of

our patients by confirming that people do not need to

be compulsive about handwashing, taking off clothes

before entering a house, and washing off groceries

before allowing them into the home. These are anxiety

measures, not the CDC measures.

Preserve a Sense of Normalcy

When social distancing is still recommended, you

can still maintain a routine by making your bed in the

morning, getting dressed for work even if you work

from home, exercise at home instead of a gym, and

have a scheduled dinner as usual but maybe invite

friends over a video chat platform. Social distancing

doesn’t mean social isolation.

Seek Out Professional Help

For many people, distressful times can reveal

underlying medical or mental health conditions that

do require professional help. Nurses can help people

recognize if what the patient is experiencing is normal

or if they need additional resources and help. This

includes being in-tune with the mental health of your

own colleagues and nurses you work with. After the

Twin Towers in New York City fell September 11, 2001,

nurses were there at the side of the firefighters and

rescue crews to assess and strengthen them in their

work. Nursing is a team sport and we need to watch

out for each other.

In the year of the Nurse, nurses really did shine and

continue to earn the title of most trusted profession.

People rely on nurses for good health education and

by being well-informed, presenting information and

resources objectively, we can collectively be a strength

to the well-being of our communities.

For ideas to help yourself, your family and your

patients, feel free to share the Coping Calendar

designed by www.actionforhappiness.org.

References

Anxiety and Depression Association of America, (ADAA)

(2020). COVID-19 anxiety reduction strategy. Retrieved

from https://adaa.org/learn-from-us/from-the-experts/

blog-posts/consumer/top-ten-covid-19-anxietyreduction-strategies

Centers for Disease Control and Prevention (2018). Influenza

Vaccination Coverage Among Health Care Personnel-

United States, 2017-2018. https://www.cdc.gov/mmwr/

volumes/67/wr/mm6738a2.htm

Pless, A., McLennan, S., Nicca, D., Shaw, D. and Elger,

B., (2017). Reasons why nurses decline influenza

vaccination: a qualitative study. BMC Nurse 2017;

16:20. Retrieved from https://www.ncbi.nlm.nih.gov/

pmc/articles/PMC5410084/

Smith, s., Sim, J., and Halcomb, E., (2016). Nurses’

knowledge, attitudes and practices regarding influenza

vaccination: an integrative review. Journal of Clinical

Nursing Oct;25(19-20). Retrived from https://pubmed.

ncbi.nlm.nih.gov/27206347/


Page 12 • Nevada RNformation December 2020, January, February 2021

Addressing Sleep Problems During the COVID-19 Pandemic

Denise S. Rowe DNP, APRN, FNP-BC

The Covid-19 Pandemic has produced significant

stressors including mass unemployment, financial

hardships, and an increase in mental and physical

health conditions. Health care workers are on the

frontline providing the first line of care to those

infected and sick due to COVID-19. Stressors from the

pandemic are high. Consequently, surveys of healthcare

workers report high incidences of problems sleeping.

Sleep is vital to the maintenance of the body’s

defense system and for promoting homeostasis. Along

with diet and exercise, healthy sleep—of adequate

quality, duration and timing is one of three pillars of

maintainable health (Goldstein and Walker , 2014),

Sleep disruptions and deficits interfere with

immune system responses by interrupting circadian

rhythms, negatively impact the endocrine system that

manage and maintain internal bodily functions and

some cytokines (IL=-1, IL-6, TNF-a) which are linked

to disease and immunosuppression (Besedovsky,

Lange, and Haack, 2019; Irwin, 2015; Santos, Tufik, &

De Mello, 2007). While sleep deficits have not been

directly linked to an increase in diagnoses of COVID-19,

immunosuppression from sleep deficits can increase

the risk for opportunistic diseases and worsen clinical

outcomes resulting from COVID-19.

When stressors are high the body often triggers an

inflammatory response to eliminate the stressors and

aid the body system in reverting back to a normal state

of homeostasis.

Since the onset of COVID-19, high insomnia rates

(34-36%) have frequently been reported among

frontline healthcare who care for patients at risk or

diagnosed with COVID-19 (Lai, et al., 2020; Zhang et

al., 2020). Healthcare workers face higher stress from

providing care to COVID-19 patients, fear of getting

infected themselves and constantly facing death

by working on the frontlines. These circumstances

contribute to sleep disturbances at home.

Epidemiological data show that nurses experience

high incidences of sleeping problems. Among nurses,

57% to 83% reported having insomnia, inadequate

sleep, sleep deprivation and poor quality of sleep

(Qiu et al., 2020; Zdanowicz, Turowski, Celej-Szuster,

Lorencowicz, & Przychodzka, 2020) , and up to 50%

of nurse worldwide reported short sleep duration

(Furihata, Saitoh, Suzuki, et al., 2020; Stimpfel, Fatehi,

& Kovner, 2019). A larger study in the United States

found that 68.1% of nurses regularly slept less than

seven hours and 11.4% slept less than five hours

(Stimpfel et al., 2019). It is important to note that the

National Sleep Foundation recommends that adults

should sleep seven to nine hours per night (Hirshkowitz

et al., 2015). Nurses experiencing sleeping problems

were at risk for committing errors at work. Dorian

and others (2006) found sleep deprivation increased

the risk of medication errors, incorrect documentation

and fostered poor communication between nurses,

patients, and other staff.

There are many strategies available to manage

or prevent sleep disturbances during the COVID-19

pandemic:

• Make sleep health a priority—set aside seven to

eight hours per night for sleep.

• If possible, maintain a regular schedule for sleep,

work and recreation which provides cues, helps

to maintain a routine and trains one’s individual

biological clock.

• For day shift workers: self-exposure to daylight

as much as possible is recommended to regulate

circadian rhythms and sleep-wake cycles.

• For night shift workers: avoid direct exposure

to sunlight on the way home from work by

wearing sunglasses.

• For night shift workers, setting an alarm to

maintain a regular wake-up schedule. Exposing

yourself to sunlight right after awakening is

recommended.

• Allow one hour or more to unwind before sleep.

• Go to bed when sleepy.

• Maintain a sleep environment that is

comfortable (e.g. dark, quiet, and at around 20

degrees Celsius/68 degrees Fahrenheit).

• If sleep does not occur within 15-20 minutes,

consider quiet activity such as reading in another

room and return to bed when sleep is imminent.

• Follow the same sleep routine to maintain a

regular sleep-wake schedule. Arise at the same

time every day. Do not sleep in regardless of

sleep duration.

• Avoid intense or blue light and use of electronic

items (television, cell phones, tablets) in

bedroom and close to bedtime. These items

inhibit the release of the sleep-inducing

hormone melatonin.

• Use stimulants (e.g. caffeinated beverages) with

caution and avoid them five to six hours before

sleep; they could have negative collateral effects

on the next sleep episode.

• Avoid alcohol before sleep. While alcohol is

initially de-arousing it has a rebound effect of

increasing night-time awakenings and reducing

restorative sleep.

• Avoid smoking or nicotine 30 minutes before

sleep. Nicotine worsens sleep quality and

increased night-time awakenings.

• Avoid eating too many sugary foods before

sleep. They can significantly activate your

metabolism and worsens sleep.

• For night shift workers, have a light snack before

bedtime to avoid being awakened by hunger.

• Reserve bedroom for sleep and sex only—not

for working or planning the next day activities.

• Following sleep deprivation, a short 15

to 30 minutes be effective in decreasing

the homeostatic burden of the sleep drive

and improving cognitive and psychomotor

functioning.

• Avoid napping five to six hours before longer

sleep if insomnia is a problem. While insomnia

can be a normal response to stressful events, if

insomnia occurs several times per week, seek

professional help to prevent insomnia from

becoming a chronic problem.

Healthy sleep is critical to coping physically and

mentally with a major life event such as the COVID-19

pandemic. Ongoing education is needed to remind

healthcare workers about the importance of healthy

sleep practices to prevent or minimize adverse health

outcomes as the COVID-19 pandemic surge continues.

References:

Besedovsky, L., Lange, T., & Haack, M. (2019). The sleepimmune

crosstalk in health and disease. Physiological

reviews, 99(3), 1325-1380.

Dorrian, J., Lamond, N., van den Heuvel, C., Pincombe, J.,

Rogers, A. E., & Dawson, D. (2006). A pilot study of

the safety implications of Australian nurses' sleep and

work hours. Chronobiology international, 23(6), 1149-

1163.

Furihata, R., Saitoh, K., Suzuki, M., Jike, M., Kaneita, Y.,

Ohida, T., ... & Uchiyama, M. (2020). A composite

measure of sleep health is associated with symptoms

of depression among Japanese female hospital nurses.

Comprehensive Psychiatry, 97, 152151.

Goldstein, A. N., & Walker, M. P. (2014). The role of sleep

in emotional brain function. Annual Review of Clinical

Psychology, 10, 679–708. https://doi.org/10.1146/

annurev-clinpsy-032813-153716 Epub 2014 Jan 31.

Hirshkowitz, M., Whiton, K., Albert, S. M., Alessi, C., Bruni,

O., DonCarlos, L., ... & Kheirandish-Gozal, L. (2015).

National Sleep Foundation’s updated sleep duration

recommendations. Sleep health, 1(4), 233-243.

Irwin, M. R. (2015). Why sleep is important for health: a

psychoneuroimmunology perspective. Annual review

of psychology, 66.

Lai, J., Ma, S., Wang, Y., Cai, Z., Hu, J., Wei, N., ... & Tan,

H. (2020). Factors associated with mental health

outcomes among health care workers exposed to

coronavirus disease 2019. JAMA network open, 3(3),

e203976-e203976.

Qiu, D., Yu, Y., Li, R. Q., Li, Y. L., & Xiao, S. Y. (2020).

Prevalence of sleep disturbances in Chinese healthcare

professionals: a systematic review and meta-analysis.

Sleep medicine, 67, 258-266.

Santos, R. V. T., Tufik, S., & De Mello, M. T. (2007). Exercise,

sleep, and cytokines: is there a relation?. Sleep

medicine reviews, 11(3), 231-239.

Stimpfel, A. W., Fatehi, F., & Kovner, C. (2020). Nurses'

sleep, work hours, and patient care quality, and safety.

Sleep health, 6(3), 314-320.

Zdanowicz, T., Turowski, K., Celej-Szuster, J., Lorencowicz,

R., & Przychodzka, E. (2020). Insomnia, sleepiness,

and fatigue among polish nurses. Workplace Health &

Safety, 68(6), 272-278.

Zhang, C., Yang, L., Liu, S., Ma, S., Wang, Y., Cai, Z., ... &

Zhang, J. (2020). Survey of insomnia and related social

psychological factors among medical staff involved in

the 2019 novel coronavirus disease outbreak. Frontiers

in Psychiatry, 11, 306.

Loneliness and Social Isolation...continued from page 5

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.

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.


December 2020, January, February 2021 Nevada RNformation • Page 13

Nurses in the News

By Tracey Long PhD, APRN

Some people are born to be a nurse. Some people are

also born with special gifts and when they’re both, the

world is blessed.

One couple, Branden Murphy and Kristine Hafner are

those kinds of people that embody the spirit of nursing.

They are both pediatric nurses in Las Vegas, Nevada who

met while trying to adopt the same child on a pediatric

unit. In the following interview, you’ll feel their passion for

children.

What made you interested in being a foster parent?

As a pediatric nurse who worked with hundreds of

children, I noticed that special needs kids who didn't get to go to a foster home

went to a skilled nursing home. That bothers me because it’s not natural for a child’s

home to be a facility. I believe kids should be at home with a family that loves them

and a dog by their side. I love special needs children. The more complex they are the

more I love them. It's just normal for me to want to give great nursing care to them.

When I turned 30, I still wasn't married, and I always wanted to be a parent.

I decided to become a single foster parent. Leon was my first foster baby. I met

Leon when he was nine days old in 2015, and he was admitted for shaken baby

syndrome. His older brother was also badly abused with multiple burns. A third

sibling was born into this dysfunctional family and Leon was the youngest. All three

children have now been adopted and the parents are currently incarcerated. I was

his foster parent for two years and then was able to adopt him as a single parent

and he was such a blessing to me. He has a G tube, is trach dependent, and has

central deafness and blindness. He has hydrocephaly as his brain couldn't develop

so he is chronologically five years old, but his ability is as a three-month-old. "They

took away 1/2 his brain by being a shaken baby," stated the grandmother. He is so

cute; I just love him!

How did you both meet?

I met my wife when we were both trying to adopt the same child, we cared for

in her PICU unit and through foster care. She had just adopted Steven, who was

beaten up at 11 months old with over 20 fractures, a deflated lung and missing

most of his teeth with a broken jaw. She has a huge heart and always wanted to

take home so many babies with special needs. We met by a mutual nurse friend.

We were both trying to adopt Skyler, a two-year-old who was born with her

intestines outside of her body, known as gastroschisis, due to parental alcoholism

and meth use.

Kristine fell in love with me when I took Leon snow sledding which made her

realize I want a normal life for these children. We both believe these children should

be able to experience life as normal. I’ve taken our special needs children swimming,

sledding and all kinds of activities to allow them a normal life, even with a trach

tube or special equipment.

Additional stories on this impressive couple can be found at:

https://news.gcu.edu/2020/05/he-advocates-for-foster-kids-in-multiple-ways/

http://epubs.democratprinting.com/publication/?i=641416&article_

id=3556812&view=articleBrowser

https://news3lv.com/features/heroes/local-nurse-takes-passion-of-the-practicefrom-the-hospital-to-home

Branden currently serves on the Nevada State Board of Nursing since 2019. He

has been working as a nursing professor for Arizona College of Nursing and after

hours he volunteers his time to be an advocate for children and providing a home to

children without options. Branden is in the process of opening Silver State Pediatrics,

which is a new skilled nursing facility in Las Vegas. He will be the Assistant Director

of Nursing.

Kristine works as a PICU nurse at Sunrise Hospital in Las Vegas, Nevada and must

work hard to not fall in love with every patient!

Image Source: family picture taken by the Murphy family through Make a

Wish Foundation. Branden and Kristine Murphy and their four children

Who are your other children?

In addition to my first son Leon and her first adopted son Steven, we have now

adopted Skyler who is dependent on permanent intravenous feedings, and our

biological daughter London. Our hobbies are really taking care of medically complex

children and becoming advocates for them. We also continue to foster medically

complex children and currently have one foster baby.

What is your advice for foster parents?

If you have the desire or ability to serve as a foster parent, it’s a great

opportunity. There are so many children who need a loving and stable home. Just

be careful because you might fall in love and want to keep the child if you’re lucky!

These kids deserve to be loved by a family.

Who pays for their care?

All the children have Medicaid. We spend a lot of time trying to navigate the

health system. We have great compassion for those who aren’t nurses and are

trying to be an advocate for their own special need’s children because it’s not an

easy process.

What is your advice for helping pediatric populations?

It is estimated that about 80-90 percent of car seats for children are installed

incorrectly so we as nurses need to educate our parent populations about correct

installation.

West Hills Hospital located in Reno, NV, a leader in

the treatment of behavioral, mental health care and

substance abuse treatment is seeking FT/PT/PRN

Registered Nurses to implement the nursing process

as it relates to our programs.

Visit www.westhillshospital.net and click on

CAREERS to apply.


Page 14 • Nevada RNformation December 2020, January, February 2021

SAVE THE DATE!

Nurses Day At The Legislature

Tuesday, March 2, 2021

Nevada State Legislature

401 S. Carson Street

Carson City, NV

Free CEU’s will be provided!

Watch for registration details on NNA’s website

https://nvnurses.org/

Rural & Frontier

Fundraiser/Symposium

JOIN US! 2-day Virtual Conference - Presented

by the Nevada Nurses Foundation (Rural & Frontier

Friendly Fundraiser)

Visit - nvnurses.org; https://nvnursesfoundation.org/

Networking and Informative Seminars

January 22, 2021 5pm to 8pm

January 23, 2021 8am to 12 pm

Nursing Continuing Education Units Available

Possible Presentations:

• Adolescent Mental Health

• Human Trafficking

• Keeping the Patient with COVID-19 Safe

• LGBTQIA+

• Medicinal Marijuana

• Opioid Abuse

• Self-Care

Register before January 1st for a discounted fee.

Students who are not members of NSNA

may join NSNA and have their registration

fees waived.

www.nsna.org

Questions?

Please contact Sandy Olguin

at sandyolguin@live.com

Scholarships to attend may be available, contact

Sandy at above email or at

775-335-9554

REGISTER HERE

FOR SYMPOSIUM

https://events.r20.constantcontact.com/register/eventReg?oeidk=

a07ehfedmq79c88affc&oseq=&c=&ch=


December 2020, January, February 2021 Nevada RNformation • Page 15

The 20/20 Vision: Nevada Nursing Student Association Empowerment

Jessica Rasamimanana, NVNSA Southern

Regional Director

Chelsey Honrud, NVNSA Secretary

Iris Isabel Martinez, NVNSA President

The Nevada Nursing Student Association (NVNSA)

has fiercely empowered Nevada nursing students

and exudes resilience. This year has brought many

opportunities, and no one could ever have imagined

it would be possible to thrive amid a pandemic.

However, NVNSA found 20/20 clarity and will only

continue to rise in the coming years. Below are two of

the most significant accomplishments NVNSA has had

the honor to participate in, as recounted by Jessica

Rasamimanana (NVNSA Southern Regional Director)

and Chelsey Honrud (NVNSA Secretary).

clinical skills. We have partnered with many of the

Southern Nevada Region schools and have student

nurse volunteers come out from UNLV, NSC, Roseman,

and CSN the first of every month and as needed. We

are so grateful to bring so many schools and people

together through this volunteering experience. When

we can help others through simple acts of kindness,

we can fully experience an event that allows us to

work cumulatively towards our goals. By supporting

our nursing students, we have allowed for expanded

knowledge of diabetes resources and the creation of

a wide range of opportunities for advancement. It has

been gratifying to be a part of something that helps to

better our community, and we cannot wait to be a part

of our next event.

As 2020 ended and we move into 2021, we cannot

wait for all the future opportunities we have yet to

encounter. Most importantly, we are eager to take on

all the many challenges to enter our path, as we have

all experienced first-hand the gift of growth and strong

leadership it brings. NVNSA would like to thank all the

fierce and resilient nurses who continue to inspire NV

nursing students and continue to show us the power of

a nurse’s heart!

Nevada Nurses Foundation SSON Student

Event & Gala: It was such an honor for several

NVNSA members to be named 'Rising Stars' as nursing

students in Nevada. To be recognized for the work we

are doing for our fellow students was so validating.

NVNSA has been providing many opportunities for

nursing students in Nevada. NVNSA hosted a virtual

event for Nevada nursing students, the Shining Stars of

Nursing (SSON) Gala. The SSON student event provided

students from all over the state with networking and

informational sessions regarding furthering their

education, financial planning, job opportunities, and

a mini NCLEX review, all free of charge. While NVNSA

provided this free to students, this occasion served as

a fundraiser for the NVNSA 2021 convention. At the

SSON Gala, we had an opportunity to meet and learn

from nurses in Nevada and gain more insight into the

profession we are about to enter. Speaking with the

"50 under 50" nurses and hearing about the fantastic

things they are doing for the nursing profession in

Nevada was inspirational; we cannot wait to join the

nursing profession officially.

SAVE THE DATE!!!

Bringing together nursing students throughout

Nevada. We are one big team! #Strongertogether

Shining Stars of Nevada: Behind the scenes

of the annual Shining Stars of Nevada (SSON)

Student virtual event, the NVNSA coordinated

and ran the student event.

• NCLEX Hurst Review

• Pharmacology Kahoot review

• Resume review + Interview tips

• Exhibitors

• Raffle prizes

• Student scholarship giveaway

• Alumni panel

• NCLEX review giveaways

• and much more!

NVNSA 3rd Annual Convention

via zoom on Saturday, May 29th @ 8am

THEME: New Grad RN Bootcamp:

No limits to success!

Support the next generation of nurses. From new graduate

RN’s, to incoming nursing students, to high school students!

We would love to see you here! #Strongertogether

More details coming soon!

*Contact president.nvnsa@gmail.com for any questions*

Live in Las Vegas!

We offer outstanding career opportunities for qualified

people who share our commitment to providing expert

healthcare and excellent customer service.

The Nevada Nurses Foundation awarded NVNSA

Board of Directors and NVNSA members the

2020 Rising Star Certificate. A huge honor and

indeed an amazing night!

D.I.V.A. Program: Another significant opportunity

that we have been able to bring to our fellow

nursing students was collaborating with the Diabetes

Intervention for a Victorious and Active Lifestyle

program, otherwise known as the D.I.V.A program.

This event was an amazing opportunity for our fellow

students to be out in the community, educate, practice

our skills, and encompass all NVNSA stands for.

These volunteers can assist with taking manual blood

pressures, blood sugar monitoring, weights, and other

Our employees enjoy opportunities for professional

development and career advancement, as well as

a competitive compensation and benefits package.

We offer:

* Growth Opportunities * Vacation, Sick, Holiday Pay

* Generous 401k * Medical/Dental/Vision

* Education Reimbursement

EOE

We are currently recruiting

full-time and per diem

Registered Nurses and

other Clinical Support

Come Join the Family! Apply online.

Recruiter: (702) 657-5580

www.northvistahospital.com


Page 16 • Nevada RNformation December 2020, January, February 2021

UMC Annual Research Empowerment Day 2020 – Virtual Edition

Heather Spaulding, MSN, RN, RN-BC, CPN

Cheri Filewood, RN

The Chief Nursing Officer of University Medical

Center of Southern Nevada (UMC), Debra Fox, had a

vision for a day where interprofessional healthcare

workers came together to support UMC’s vision of

being a premier academic medical center. Her vision

became a reality on May 9, 2018, when UMC hosted

their First Annual Research Empowerment Day. This

day's three objectives are to bring evidence-based

practice to the bedside, recognize research excellence

formally, and enhance UMC's partnership in higher

learning (Neue & Walker, 2018).

The First Annual Research Empowerment Day set

the foundation for the future of research at UMC.

The first event was held at UMC and featured 54

posters in the categories of care presentations, clinical

research, completed clinical projects, proposed clinical

projects, and knowledge enhancement. Poster authors

represented medicine, nursing, therapies, pharmacy,

academia, and even engineering. A neutral panel

of judges reviewed the posters using preset criteria.

Winners were announced during a live event with

certificates and ribbons presented. This first event's

overwhelming response established a platform for

highlighting clinical research (Walker, 2018). Contact

hours for continuing education were awarded for

attending the event and completing the event’s

evaluation.

Building upon the first year's success, the Second

Annual Research empowerment Day showed growth

with an additional twenty posters. On September

11, 2019, 74 posters were featured from different

interprofessional team members from UMC (UMC

Hospital, 2019) and healthcare professionals in

academia. Posters were judged using the same five

categories for the second year, and winners were

announced during a live event with certificates and

ribbons presentations.

With the success of the first two years, UMC's

Research Empowerment Day Committee had set a goal

to feature 100 posters for 2020. There was a plan to

add two additional categories for healthcare profession

students–undergraduate and healthcare professions

students–graduate to allow future healthcare workers

such as medical students, nursing students, therapy

students, and more to highlight their work in a

professional venue. As the planning committee began

to plan the Third Annual Research Empowerment

Day, the world suddenly found itself in the middle

of a pandemic. All healthcare-related conferences

and UMC's Research Empowerment Day came to

a screeching halt while our frontline staff worked

diligently to assist patients affected by this new disease.

The healthcare community began to learn more

about this new virus, and the Centers for Disease

Control and Prevention (CDC) put guidelines in place

to keep everyone safe. The CDC asked everyone to

practice social distancing (CDC, 2020) and limit large

gatherings. With the new social distancing guidelines

in place, those who plan conferences and events

to advance healthcare knowledge began to seek

alternatives to these types of events.

Working with the UMC's Infection Preventionists,

incident command, and senior leadership, the planning

committee was approved to move forward with a

virtual venue. A call for posters went out. Despite

the short notice, the planning committee was able to

obtain participants to partake in the third annual event,

demonstrating that the healthcare community desired

to grow from research even during difficult times.

With the new virtual venue, the committee sought

to ensure that guests outside of UMC could participate

in the event. The planning committee worked diligently

with the marketing team and the web developer to

create this new virtual venue. Twenty-six posters were

accepted from various UMC disciplines and two from

our academic partners to total twenty-eight posters.

These posters were the displayed on UMC’s webpage

within their respective categories.

With the social distancing guidelines, another

challenge the planning committee faced was the

annual award celebration. The planning committee

concluded that the best way to celebrate was to host

a virtual celebration via WebEx, with posters on virtual

display on November 18 and 19, 2020. This event

concluded on November 19, 2020, from 1030 to

1200, with authors present to answer the attendees'

questions. The event started with welcomes from

UMC's CEO and CNO and a brief presentation of

posters by poster authors, followed by the poster

winners' announcement.

Despite a global pandemic, UMC has seen active

participation in the Annual Research Empowerment

Day initiative. Due to our healthcare workers' busy

schedules, the posters are approved to remain as an

active Continuing Education event for a full year. The

ongoing poster displays will allow additional UMC staff

and all healthcare providers in Nevada and beyond, to

visit the site and obtain FREE 1.5 Contact Hours using

the link below.

www.umcsn.com/virtualposterday

UMC thanks all healthcare workers near and far for

their service. We hope you will take the time to visit

our site, review the posters, and complete the survey to

obtain your free contact hours.

References

CDC. (2020, Nov 17). Social distancing: Keep a safe

distance to slow the spread. Retrieved from Centers

for Disease Control and Prevention: https://www.cdc.

gov/coronavirus/2019-ncov/prevent-getting-sick/socialdistancing.html

Neue, P. C., & Walker, V. (2018, March). UMC hosts first

annual research empowerment day. Nevada State

Board of Nursing News, p. 23. Retrieved from http://

epubs.democratprinting.com/publication/?m=11381&i=

486576&p=22&article_id=3052224&ver=html5

UMC Hospital. (2019, September). UMC Hospital @UMCSN

Tweet. Retrieved from https://twitter.com/UMCSN/

status/1172620856058494978

Walker, V. (2018, September). 2018 UMC Research

Empowerment Day. Nevada State Board of

Nursing News, p. 8. Retrieved from http://epubs.

democratprinting.com/publication/?m=11381&i=52925

3&p=8&ver=html5

Registered Nurses

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boating, fishing or any other sport you like! You can

even ride your bike to work! Save money, less time

commuting and spend more time with your family!

Working conditions, taxes and health are better

here in Douglas County than in any other county in

Northern Nevada. It’s greener on this side of Nevada -

rugged, relaxed, reachable! Come join the family. At

Carson Valley Medical Center Hospital we are seeking

to expand our Nursing staff. Located in Gardnerville

Nevada, 20 miles from beautiful South Lake Tahoe,

CVMC is a full-service critical access hospital.

CVMC supports an ICU unit, med tele unit, outpatient

infusion center, ambulatory surgery center and 24

hour ER. 6 months recent critical care experience

required. Successful applicant will be scheduled

a combination of shifts in the ICU and Med-Surg/

Telemetry department.

CVMC offers competitive wages and benefits, plus a

retention bonus of $5,000 over 2 years employment.

Interested applicants please apply online at

cvmchospital.org or call 775-782-1514.


December 2020, January, February 2021 Nevada RNformation • Page 17

Leadership in Policy and Care Quality and Safety

Nursing Policy in Times of Uncertainty surviving, thriving on the edge

As we confront new and existing realities and move

into this decade launched by the Year of the Nurse

and Midwife, we critically examine the history and the

future of nursing by inaugurating a new column called,

Leadership in Policy, Care Quality and Safety. The

purpose of the column is to engage nurses in dialogue

and galvanize them to take leadership in the individual

but overlapping aspects of policy, care quality and

safety. Each quarter you will find a short column on

a topic related to one or more of these intersecting

factors. Leadership is the framework that underpins

each column. We believe that no matter where nurses

work or the position held, leadership is a critical skill

for all nurses not only those who hold titles that imply

leadership, e.g. manager, director, dean, but every

nurse regardless of practice setting or role. Our goal is

to raise awareness about the leadership opportunities

in policy, care quality, and safety across settings,

specialties, communities and the globe by focusing on

inspiring exemplars and action steps that that be taken

by nurses.

Rebecca M. Patton, DNP, RN, CNOR, FAAN

Margarete L. Zalon, PhD, RN, ACNS-BC, FAAN

Ruth Ludwick, PhD, RN-BC, APRN-CNS, FAAN

Marian K. Shaughnessy Nurse Leadership

Academy, Case Western Reserve University

https://case.edu/nursing/nurse-leadershipacademy

Call to Action

As we write this column during the COVID-19

pandemic, we are in the midst of unprecedented

change and risk for our personal lives, our families,

our professional lives, our communities, our country,

and our world. Little did we think when we planned

this column about policy, leadership, quality and

safety that we would be facing one of the greatest

challenges in our lifetimes. This crisis has thrust nurses

into the forefront of the public’s mind. How ironic that

this coincides with the World Health Organization’s

declaration that this is the Year of the Nurse and the

Midwife. While nurses are essential on the frontlines

at the sharp edge of care, it is the lens of nurses that

provide critical insights in evaluating and formulating

policy to achieve quality and safety patient care

outcomes.

Everyday nurses walk the tightrope of uncertainty.

The uncertainty of practice is a constant that

requires the attention of all nurses, vigilance, and

most importantly activism. COVID-19 has magnified

these unknowns to astronomical proportions. The

accelerated pace of uncertainty with COVID-19 has led

to care dilemmas and crises, with variations in practice

standards that negatively impact health outcomes.

We are bombarded with challenges like mass

shootings, climate change, water supply, and emerging

diseases. Now we are in the midst of a pandemic,

which not only impacts the health of our communities

and workforce, but has dire financial consequences

for so many. How many of these challenges have

you faced? What challenges have you faced that are

not even listed here? What will come next? We don’t

always know what will come next. We do know that

nurses will be there on the frontlines. When nurses

are asked to volunteer in a crisis, they show up for

wars, disasters, and pandemics. Nurses are in the

frontlines of policy implementation. Often in times of

crisis, policies are disregarded, ignored, or unofficially

discarded. Nurses often know whether a policy is

workable, flawed or whether it is doomed to fail. We

have seen policy failures like changing instructions

on the use of personal protective equipment (PPE) as

supplies dwindle. On the other hand, times of crisis

can lead to policy gains as illustrated by a willingness

to allow advance practice registered nurses full practice

authority.

To counteract policy failures, correct flaws and take

advantage of opportunities for policy advancements,

we need to be knowledgeable, and prepared. This

means participating in policy so that we understand

concerns expressed by broad constituencies and take

action using our nursing expertise. This expertise is

needed so that the policies are realistic, workable and

meet the needs they were designed to address. Policy

is more than enacting a law; it includes formulating

rules, regulations and guidelines. Policies occur at many

levels, often simply referred to as Big “P” and little “p”,

the former often focus on state, federal or international

laws and the latter to local government or local

associations or organizations.

Move to Action

Moving to action requires identifying the preferred

outcome with clarity. This is achieved by examining the

data, sharing information, and capitalize on your skills

to move an issue forward.

Know the data, appraise credibility of sources, and

interpret its meaning

“In God we trust, but everyone else needs to bring

data”

This quote attributed to Edward Fisher when

testifying before Congress (Source) is a fitting start

for policy involvement. Nurses have the knowledge

and are in a unique position to use and leverage data

for patient advocacy. Knowing the data, appraising

sources and interpreting its meaning are critical steps

in the processes for research, quality improvement and

evidence-based practice. Nurses all have intellectual

capital related to these processes regardless of their

practice setting or role. Your intellectual capital can be

enhanced with the following strategies:

• Use the resources available from professional

associations: the American Nurses Association,

state nurses associations, specialty nurses

associations and interdisciplinary professional

groups.

• Subscribe to a wide variety of data sources

including journals, news alerts, list servs

• Track and identify progress on issues you are

passionate about

• Determine the credibility of sources

• Verify the facts

• Identify content experts for policy issues

• Interpret the meaning

• Identify policy implications of research and

quality improvement projects

• Identify the strengths and weaknesses in the

data in support of your

• Sift fact verifying the facts and determining the

credibility of sources

• Interpret the meaning of information

Have the stories, share them widely.

Stories can be more powerful than only presenting

data. Stories provide an emotional tug, create drama,

and provide context. Stories get attention, but data

strengthens the power of stories. Most stories have

multiple audiences. Framing your story in a way that

varying audiences understand transmits important

knowledge and fosters identification with stark

realities. Storying telling is subject to several caveats.

With the advent of social media, sharing stories has

become easier, it also has created a medium for

false stories to grow exponentially (as they are often

salaciously framed). Second, be aware of people

and organizations that try to block stories, especially

when bad news happens. (p 320 book) As the most

trusted profession, nurses have a strategic position

opportunity to frame and share their narratives widely

with a variety of audiences at the little p to the Big P

to level as outlined below varying audiences and frame

stories using the following avenues. These strategies

are not static and can be adapted to the virtual world.

Garnering the support of colleagues, stakeholders and

the public can be accomplished with these strategies:

• Post digital content (social media)

• Disseminate facts and reports in print media

(fact sheets, policy briefs, articles, letters, press

releases)

• Disseminate research findings

• Engage key stakeholders

• Contact legislators about key issues on an

ongoing basis and when votes come up

• Speaking up at public meetings

• Presenting in public forums

• Model inspirational behaviors

• Participate in town hall meetings

• Meet with legislators and regulators

• Create elevator speeches

• Be social media savvy

Know your skills, capitalize on them.

Nurses have the skills to move beyond only being

implementers of policy and only on the sharp edge of

policies; we need to be the developers of policies. To

capitalize on the potential of four million nurses, all

nurses in any setting or role need to assess how their

skills can be applied to policy. This positions nurses to

enhance practice and the work environment as well as

advance issues of importance to nurses and the public

we serve. Policy work needs to become ingrained as

part of the culture of nursing. P. 470

Common and overlooked strategies to improve an

individual policy role would include the following which

you can act upon immediately :

• Register and vote

• Be a poll worker

• Join interest-based organizations and become an

active member

• Finding a mentor

• Volunteer to work on a campaign.

• Serve on a workplace committee, task force or

practice council

• Attend networking events

• Participate in legislative days

• Contribute to candidates and political action

committees

• Complete your profile for Nurses on Boards

(nursesonboard.org)

• Seek local community board positions

• Communicate with elected officials

• Capitalize on workplace communication

channels for policy discussions

• Volunteering for an organizational or

community-based initiative

The following are generally are longer term actions,

but can be done in the short-term as well depending

your policy trajectory:

• Assume a leadership role for a workplace

committee, task force or practice council

• Be a mentor

• Representing your organization to the external

community

• Seek an internship or fellowship with a legislator

or other policymaker

• Further your formal policy and content education

• Serve on a political action committee board

• Seek a board position

• Volunteer for appointed office

• Run for office in your organization or community

In times of uncertainty, there are certainties. One

certainty is the mandate for all nurses becoming

involved in policy. The American Nurses Association’s

Code of Ethics for Nurses’ (2015) supports nurses’ roles

in policy with the expectation that nurses advocate

for the health and safety of patients, collaborate in

the promotion of health, work to improve the ethical

environment of practice settings, and advance the

profession through nursing and health policy.

We have highlighted strategies that nurses should

use to increase their involvement in making policy

decisions to strengthen our practice and improve the

health of the public we serve. The collective action of

over four million nurses in our country and 21 million

nurses across the globe has the potential to be a

powerful force for policy change.

American Nurses Association. (2015). Code of Ethics

for Nurses with interpretive statements. Silver Spring,

MD: Author. https://www.nursingworld.org/practicepolicy/nursing-excellence/ethics/code-of-ethics-fornurses/


Page 18 • Nevada RNformation December 2020, January, February 2021

Nevada Nurses Foundation EST 2014

Rural & Frontier Nursing Scholarship Fundraiser

Join us on Friday, January 22nd and

Saturday, 23rd, 2021

2-day Virtual Conference Networking &

Informative Seminar

Brian Dankowski

Karen Bearer

Denise Ogletree

McGuinn

Presentations:

• Adolescent Mental Health

• Keeping the Patient with COVID-19 Safe

• Caring for the Patient who identifies with LGBTQ

• American Cannabis Nurses Association

• Opioid Abuse

• Holistic Nurses Association

The Rural & Frontier Nursing Scholarship is awarded

to a rural certified nursing assistant, licensed practical

nurse, or a registered nurse pursuing an advanced

nursing degree. For more information, please contact

us at solguin@nvnursesfoundation.org or 775-560-

1118.

Rural & Frontier Nurse Recipients

Important 2021 Nevada Nurses Foundation Dates:

2021 Rural & Frontier Nursing Symposium

January 22 and 23, 2021

2021 7th Annual Big Hat High Tea

March 27, 2021 (COVID-willing) at the NV Governor’s

Mansion

2021 Grant Application

October 1, 2020 to February 1, 2021

2021 Scholarship Application

February 1-28, 2021

August 1-28, 2021

2022 Grant Application

October 2, 2021 to February 1, 2022

2021 6th Annual Shining Stars of Nursing Student

Nurse Event

October 2, 2021 (student nurse conference)

2021 6th Annual Shining Stars of Nursing in Nevada

Awards Gala

October 2, 2021 in Las Vegas, Nevada

2021 Tuesday Giving

November 30, 2021

In 2014, the Nevada Nurses Foundation (NNF)

gained federal recognition as a 501(c)(3), non-profit

organization. The mission is to increase access to

quality healthcare for Nevada citizens by promoting

the professional development of nursing through

scholarships, grants, and recognition.

The NNF started with an idea which lead to many

discussions, a lot of paperwork, collaboration, and a

healthy amount of time, money, and commitment.

Thank you to the initial NNF Board of Directors, Mrs.

Margaret Curley, Barbara Wardwell, and Calmoseptine

for believing in the NNF!

Photographed: The first Nevada Nurses Foundation

Board of Directors from left to right, Elizabeth Fildes

(Director), Denise Ogletree McGuinn (Vice President),

Sandy Olguin President), Betty Razor (Treasurer), and

Susan Growe (Secretary).

Nevada Nurses Foundation Values

• Integrity: the quality of being honest and having

strong moral principles.

• Collaboration: the action of working with others

to produce or create something.

• Quality: a distinctive degree of excellence; high

standard or condition.

• Stewardship: the action of being fiscally

responsible.

The first scholarships were awarded in 2015 to the

following nurses:

• Doreen Begley; $1,000.00, NNF RN to BSN

Scholarship

• Annie Carlos; $1,000.00, Vroman & Wildes

Scholarship

• Linda Cirillo; $1,000.00, NNF Pre-lic Scholarship

• Amy Edelman; $1,000.00, Arthur L. Davis

Publishing Scholarship

• Robin Hollen; $1,000.00, Vroman & Wildes

Scholarship

• Heidi Johnston; $2,500.00, NNF Doctorate

Scholarship

• Maria Poggio D’Errico; $2,500.00. NNF Master’s

in Nursing Scholarship

• Delene Volkert; $1,048.00 Nevada Nurses

Association Legacy Scholarship

• Michael York; $500.00, NNF Pre-lic Scholarship

• Richard Young; $500.00, NNF Pre-lic Scholarship

2020 Nevada Nurses Foundation Board of

Directors

President/CEO: Dr. Sandy Olguin

Vice President: Rev. Dr. Denise Ogletree McGuinn

Chief Financial Officer: Nicki Aaker

Treasurer: Dr. Glenn Hagerstrom

Secretary: Karen Bearer

Director & Community Outreach: Dave Tyrell

Director & Community Outreach: Dr. Heidi Johnston

Photographed: Dave Tyrell, Sandy Olguin, Karen

Bearer, Denise Ogletree McGuinn, and Glenn

Hagerstrom. Missing Nicki Aaker and Heidi Johnston

Please join me in welcoming new NNF Advisory

Board members; Dr. Caren Jaggers, Dr. Sherri Lindsey,

and Lauren Parker!

Allyson Waldron, RN

2016

Annette Clark, RN

2017

Christina Scilacci,

CNA 2019

Stephanie

McGilvrey, RN 2017

Register for Elko Symposium Here!

2020 Scholarship Recipients

Spring

• Nicole Cabrera-Heiring, BSN, RN, CLC;

$1,000.00, NNF Scholarship Recipient

• Anna Maria Holder, CCMA, BS, $1,000.00, NNF

Scholarship Recipient

• Yolanda Gardner, RN, ASN; $1,000.00, NNF

Scholarship Recipient

• Wendy Merchant, MSN-Ed, CNS, RN; $1,000.00,

NNF Doctorate Scholarship

• Casey Pruyt, CNA, AA; $1,000.00, NNF CNA-RN

Scholarship Recipient

• Masha Zelenin, RN; $1,000.00, 2020 Jessie J.

Valentine Scholarship

Fall

https://events.r20.constantcontact.com/register/eventRe

g?oeidk=a07ehfedmq79c88affc&oseq=&c=&ch=


December 2020, January, February 2021 Nevada RNformation • Page 19

Nevada Nurses Foundation EST 2014


Page 20 • Nevada RNformation December 2020, January, February 2021

Nevada Nurses Foundation EST 2014

Congratulations Nevada Nurses Foundation scholarship recipients! Thank you

for pursing your education! We are so PROUD of YOU! Thank you to all of our

scholarship donors and Legacy Scholarship sponsors.

Thank you to the Nevada Nurses

Foundation Endowment sponsors for

establishing an endowed scholarship fund

and placing your trust in the Nevada Nurses

Foundation!

The following endowments have raised

nearly ~$70,000.00.

• Karen Bearer; Frontline Heroes

Endowment Fund

• Erick Christopherson Endowed Legacy

Scholarship

• Margaret and Ian Curley Endowed

Nursing Scholarship

• Greg Peistrup Endowed Legacy

Scholarship

• Debra & John Scott Endowed Nursing

Scholarship

• Yvette Wintermute Legacy Scholarship

Endowment

Debra Scott and Dr. John Scott

Margaret and Ian

Curley

Erick Christopherson

Greg Peistrup

Yvette

Wintermute

Karen Bearer, sponsoring

Frontline Heroes

Endowment Fund

To access electronic copies of the

Nevada RNformation, please visit

http://www.nursingALD.com/publications

Threads of eNVy, a local Las Vegas business, has been very generous to the

Nevada Nurses Foundation. They created these amazing T-shirts as a way to give

back and support nurses in Nevada. The NNF receives proceeds from the sale of the

Support Local Heroes shirt.

Purchase your T-shirt at Threads of eNVy.

Follow, Like and share their Instagram page.

The Big Hat High Tea normally held at the Governor’s Mansion, was interrupted

by the COVID-19 pandemic where we moved our event from March to August 2020

and from in-person to virtual. Recognizing and honoring our scholarship and grant

recipients wasn’t the same this year, however, we celebrated everyone, listened to

amazing entertainers and had a wonderful time!


December 2020, January, February 2021 Nevada RNformation • Page 21

Nevada Nurses Foundation EST 2014

Thank you, Rev. Dr. Denise Ogletree McGuinn for

being the Mistress of Ceremonies from the comfort

of your home in Las Vegas. Thank you Karen Bearer

and Dr. Mary Bondmass for traveling from Las Vegas

to Reno to help with the virtual tea. Thank you for

presenting. Your valuable contributions prior to

and during the event went above and beyond my

expectations. Thank you, Nicki Aaker for presenting

and creating the souvenir program. You’re a hard

worker and a reliable team member. Thank you

Alyx Olguin, for volunteering and coordinating food

and beverages for everyone! Thank you, Dr Glenn.

Hagerstrom, for taking care of all the financial matters,

including raffle ticket sales and silent auction payments

all the way from Florida. Thank you, Lyle Pritchett, for

creating a wonderful online silent auction!

• 2019: Mary Poppins

2020: Crowns & Tiaras

2020 Shining Stars of Nursing Student Event

Saturday, October 3, 2020.

Chelsey Honrud (NVNSA secretary), Jessica

Rasamimanana (NVNSA So. Regional Director),

Iris Martinez (NVNSA President), Katie

Rutherford (No. Regional Director), and Karen

Nava (NVNSA Breakthrough to Nursing Director)

Karen Nava & Katie

Thank you to our wonderful Silent Auction Donors

and Winners!! Painting created and donated by Blair

Latos, RN!

Thank you to the Nevada Nurses Association

District 1 for sponsoring $500 toward the raffle prizes.

Congratulations to our raffle prize winners.

$500 Visa Gift Card: Jolinda Cabras Ramos

$300 Southwest Airline Voucher: Dr. Heidi Johnston

$200 Amazon Gift Card: Mitzi Husbands

Thank you to our NNF Big Hat High Tea Planning

Team and silent auction sponsors.

Iris Martinez & Katie Rutherford leading the 2020

Shining Stars Student Nurse Event.

Jessica Rasamimanana

Erika Manasewitsch, Shelby Pauletto,

Robert Branda, & Sean Lacsamana

Thank you, Darlene Salvo, NNF

Advisory Board member and NNF

Entertainment Director for directing

an amazing entertainment line-up.

Many thanks to Marsh Broeder, The

Fabulous Trio (Robert Branda, Erika

Manasewitsch, Shelby Pauletto),

Robert Miller, Darlene and Martin

Salvo,

Marsh Broeder Thank you, Kelly Farley, for your

wonderful silent auction pictures

and behind the scenes wizardry needed to run the

Zoom event. Your resilience, optimism and cleverness

are valuable attributes!

Every year, we change the theme of the Big Hat

High Tea. Let’s see if you can match the year with the

theme.

• 2015: Over the Rainbow

• 2016: My Fair Lady

• 2017: Mad Hatter

• 2018: The Wild West Tea

Mary Bondmass and Lauren Park

Karen Bearer

CCSD, SOUTHWEST CAREER

& TECH HIGH SCHOOL

seeking full-time CNA Instructor

Must be a licensed nurse.

Contact Donna Levy, Principal

Levydm@nv.ccsd.net


Page 22 • Nevada RNformation December 2020, January, February 2021

Nevada Nurses Foundation EST 2014

2020 People’s Choice Director of Nursing

Congratulations, Tracey McCollum, Carson Tahoe

Health’s Shining Stars of Nursing in Nevada 2020

People’s Choice DON! You’re amazing!

Tracey McCollum, MSN, RN, CENP, NEA-BC has just

been appointed to be a Board Member on the Nevada

State Board of Nursing! Congratulations, Tracey!

Tracey was joined by her Carson Tahoe Health

Family! Cassidy Jost, Danielle Dare, Joanne Miller, Kim

Kammann, Megan Martinez, Janelle Martin, Maria

Freed, Jim Freed, and Dee Tison!

Beth and Darren Melton

Seeking Adventurous,

Compassionate Nurses

Doris Bauer, 2020 Distinguished Nurse Leader

with Lifetime Achievement

Primary

Stroke

Center

Knee Hip

Replacement Replacement

Spine

Surgery

Pain

Management

Chest

Pain

Center

Leapfrog

Award

Patient

Safety

Award

Looking for Exceptional Nurses...

Northern Nevada Medical Center offers progressive employee

programs including a culture of Service Excellence that honors

outstanding employee efforts at every level. We provide a generous

benefits/compensation package, 401K and tuition reimbursement.

You’ll enjoy the innovative approaches to personalized health care

in our 124-bed acute care hospital located on a scenic hillside over

looking the Truckee Meadows in Sparks, NV.

For more information, please call Leah Webb at

775-356-4085 or visit www.nnmc.com/careers.

2375 E. Prater Way,

Sparks, NV 89434


December 2020, January, February 2021 Nevada RNformation • Page 23

Nevada Nurses Foundation EST 2014

SAVE THE DATE: Shining Stars of Nursing in Nevada

in LAS VEGAS, NV on Saturday, October 2nd, 2021!

There are many foundations and organizations

competing for your funds and on behalf of the Nevada

Nurses Foundation, we appreciate your past and future

support and charitable donations.

Thank you and have great days,

Sandy

Previous Big Hat High Tea themes include My Fair

Lady (2015), Mary Poppins (2016), Mad Hatter (2017),

Over the Rainbow (2018), and Crowns and Tiaras

(2019), and The Wild West Tea on the Comstock.

Facebook: @NevadaNursesFoundation

Instagram: Nevadanursesfoundation_

LinkedIn: https://www.linkedin.com/company/

nevada-nurses-foundation/

Twitter: @NNF_nurses

Legal Representation for

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If the board calls, we have the answer!

Our attorneys have been protecting the livelihood of

doctors and nurses in Nevada for over 40 years.

Clark Hill is a multidisciplinary, national law firm that

draws on our attorneys’ industry and policy knowledge,

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jhunt@clarkhill.com

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