Nevada RNformation - December 2020
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<strong>December</strong> <strong>2020</strong> • Volume 30 • Number 1<br />
www.nvnurses.org<br />
<strong>Nevada</strong><br />
RNFORMATION<br />
Inside<br />
articles<br />
2 Preparing Patients for COVID-19<br />
Vaccination<br />
3 Trickle Charge Your Self-Care<br />
During This Ongoing Crisis<br />
4 NNA’s Current and New Members<br />
THE OFFICIAL PUBLICATION OF THE NEVADA NURSES ASSOCIATION<br />
The <strong>Nevada</strong> Nurses Association is a constituent member of the American Nurses Association<br />
Quarterly publication direct mailed to approximately 1,000 RNs and LPNs and<br />
delivered electronically via email to 40,000 RNs and LPNs in <strong>Nevada</strong><br />
RED ROCK CANYON<br />
CLARK COUNTY, NEVADA<br />
The President’s Message<br />
5 Loneliness and Social Isolation<br />
Cause Emotional Pain in the<br />
Elderly<br />
7 Taking Time for Self-Care during<br />
COVID<br />
11 Healthy Nurses<br />
12 Addressing Sleep Problems During<br />
the COVID-19 Pandemic<br />
13 Nurses in the News<br />
15 The 20/20 Vision: <strong>Nevada</strong><br />
Nursing Student Association<br />
Empowerment<br />
16 UMC Annual Research<br />
Empowerment Day <strong>2020</strong> - Virtual<br />
Edition<br />
regular features<br />
6 Research & EBP Corner<br />
Mary Bondmass, Ph.D., RN, CNE, President,<br />
<strong>Nevada</strong> Nurses Association<br />
Mary.bondmass@unlv.edu<br />
As we move into 2021, many<br />
issues continue to confront<br />
us as nurses individually and<br />
collectively as a profession. The<br />
relentless severe acute respiratory<br />
syndrome coronavirus 2 (SARS-<br />
CoV-2), which causes COVID-19,<br />
has been a continued stressful<br />
presence since March of <strong>2020</strong>,<br />
and unfortunately, it is still with<br />
us. However, as we welcome in<br />
the new year, there is hope in<br />
several vaccines, yet there is much to be done before we<br />
even approach getting back to 'normal,' whatever that is.<br />
In a recent NNA Board meeting, my colleagues<br />
and I discussed the pandemic, the current staggering<br />
numbers of infected people in <strong>Nevada</strong>, subsequent<br />
hospitalizations, and ultimately deaths in some cases. You<br />
may or may not know, but your NNA Board consists of<br />
an eclectic group of nursing faculty, public health and<br />
hospital administrators, retired practitioners, front line<br />
staff nurses, and advanced practice registered nurses<br />
(APRNs). In our recent discussion, all expressed sentiments<br />
of being overwhelmed and somewhat helpless and<br />
sometimes hopeless about what more we could do given<br />
the pandemic's current state; these feelings seemed the<br />
same, no matter which area of nursing we respectively<br />
represented.<br />
NNA has implemented several initiatives, including<br />
providing COVID-19 education on our website (from<br />
the CDC and ANA), developed a non-staff nurse<br />
volunteer database, and purchased and distributed<br />
personal protective equipment (PPE) to <strong>Nevada</strong> nurses.<br />
Still, as the number of COVID-19 cases continued to<br />
grow, we asked ourselves what else we could do.<br />
Despite the good news of vaccines, we know that<br />
the dire situation and the COVID-19 strain on individual<br />
nurses and the entire <strong>Nevada</strong> healthcare system may<br />
continue well into 2021 and may even get worse<br />
before it gets better. So what else? We came up with a<br />
few other engaging ideas in our Board discussion, and I<br />
want to share them with the entire RNF readership.<br />
As nurses, anyone of us could make sure we stay<br />
informed of the most recent, evidence-based facts of<br />
COVID-19 and correct misinformation whenever and<br />
wherever it occurs (and unfortunately, there is still<br />
a lot of misinformation out there). While the world<br />
learns more about this novel virus and information<br />
rapidly changes, please use the NNA website to<br />
access this free and accurate COVID-19 information.<br />
Once we have the facts, we could disseminate those<br />
The President’s Message continued on page 2<br />
8 NNA Environmental Health<br />
Committee<br />
10 Antimicrobial Stewardship -<br />
Infection Prevention<br />
17 Leadership in Policy and Care<br />
Quality and Safety<br />
18 <strong>Nevada</strong> Nurses Foundation<br />
Volunteers Needed<br />
SERVNV.ORG<br />
Help is needed to distribute the Covid vaccines.<br />
Please consider volunteering.<br />
current resident or<br />
Presort Standard<br />
US Postage<br />
PAID<br />
Permit #14<br />
Princeton, MN<br />
55371<br />
Mark Your Calendars<br />
• 2-day Elko virtual Fundraiser/Symposium<br />
CEUs available!<br />
January 21 (5-8pm) & January 22 (8-12)<br />
• Nurses Day at the Legislature - March 2, 2021<br />
Vaccine Volunteers Needed!
Page 2 • <strong>Nevada</strong> <strong>RNformation</strong> <strong>December</strong> <strong>2020</strong>, January, February 2021<br />
NNA Mission Statement<br />
The <strong>Nevada</strong> Nurses Association promotes professional nursing practice through Preparing Patients for COVID-19<br />
continuing education, community service, nursing leadership, and legislative<br />
activities to advocate for improved health and high quality health care for citizens of<br />
Vaccination<br />
<strong>Nevada</strong>.<br />
NNA State Board of Directors<br />
Mary D. Bondmass, PhD, RN, CNE Mary.bondmass@unlv.edu ..............President<br />
Nicki Aaker, MSN, MPH, RN, CNOR, PHCNS-BC naaker@aol.com .......Vice President<br />
Sherrie Sherk-Olson, BSN .........................................Secretary<br />
Glenn Hagerstrom, PhD, APRN, FNP-BC, CNE ghagersrom@unr.edu .........Treasurer<br />
Arvin Operario ...........................................Director at Large<br />
Christa Secord, MSN, FNP-BC cjsecord@gmail.com ................Director at Large<br />
Norman Wright, RN, BSN, MS info@f441.com ...................Director at Large<br />
Darlene Bujold, BSN, RN darlene.cbrn@gmail.com ...............President, District 1<br />
Margaret Covelli, DPN, RN Margaret.covelli@umcsn.com ..........President, District 3<br />
Editorial Board<br />
Managing Editor, Linda Bowman, RN, lbowman@nvnurses.org<br />
Print Editor, Kathy Ryan, MSN, RN-BC<br />
Mary D. Bondmass, PhD, RN, CNE<br />
Tracey Long PhD, APRN-BC<br />
Lisa Pacheco, MSN, RN<br />
Bernadette Longo, PhD, RN, FAAN<br />
Vicki Walker DNP, BS RN<br />
Are you interested in submitting an article for publication in RNFormation?<br />
Please send it in a Word document to us at lbowman@nvnurses.org. Our<br />
Editorial Board will review the article and notify you whether it has been<br />
accepted for publication.<br />
If you wish to contact the author of an article published in RNFormation,<br />
please email us and we will be happy to forward your comments.<br />
www.nvnurses.org<br />
Published by:<br />
Arthur L. Davis<br />
Publishing Agency, Inc.<br />
Susan S. VanBeuge, DNP, APRN, FNP-BC, FAANP<br />
Over the past ten months, the world of practice has<br />
changed for all providers, from hospital service to outpatient<br />
care. One common theme discussed has been the anticipation<br />
of a vaccine for COVID-19. Vaccine distribution is expected<br />
in late <strong>2020</strong> and early 2021 throughout the United States<br />
and the world. Distribution and allocation are planned by<br />
the Centers for Disease Control and Prevention (CDC, <strong>2020</strong>).<br />
There are five phase-3 clinical trials for a COVID-19 vaccine in<br />
the United States at the time of this writing.<br />
In my practice, reviewing immunization status is the<br />
norm, but this year my assessment has considered the<br />
upcoming COVID-19 vaccine. Reminders of updating the flu<br />
vaccine are standard during encounters in the season, and then the conversation is<br />
followed by education about the COVID-19 vaccine. Utilizing the CDC's resources, I<br />
have been able to incorporate teaching and preparation for my patients. I've noted<br />
many patients express concern, and more than a few are hesitant to commit to<br />
taking the vaccine once it is available.<br />
The CDC offers providers resources to engage in a compelling conversation about the<br />
COVID-19 vaccine with their patients. There are five techniques and strategies suggested<br />
to start the vaccine's conversation with your patients (table 1). The recommendation is to<br />
start from a place of understanding and empathy, assume they will want a vaccination<br />
but may have limited knowledge, give your strong recommendation as their provider,<br />
listen and respond, and summarize the discussion (CDC, <strong>2020</strong>).<br />
Table 1<br />
Questions<br />
1. Start from a place of empathy and understanding.<br />
2. Assume patients will want to be vaccinated but may not know what to expect.<br />
3. Give your strong recommendation.<br />
4. Listen to and respond to patient questions.<br />
5. Wrapping up the conversation.<br />
https://www.cdc.gov/vaccines/hcp/covid-conversations/engaging-patients.html<br />
As we navigate our patients' questions, concerns, and fears, we can equip<br />
ourselves with updated information regarding the vaccine and distribution plans<br />
within the community. One aspect of the COVID-19 pandemic that has become<br />
clear is how vulnerable patients feel about the virus and the unknown future, which<br />
may cause uncertainty with the vaccine. Directing patients to reputable sources to<br />
learn details and information will increase confidence. The CDC suggests strong<br />
recommendations coming from their healthcare provider are critical for vaccine<br />
acceptance. Sharing vaccines' importance to protect health and those in their<br />
community may be important points to emphasize during the conversation.<br />
As practice enters another phase of the COVID-19 pandemic, another aspect<br />
of our roles evolves to incorporate education regarding the vaccine. Being firmly<br />
grounded in understanding the science, efficacy, and distribution planned<br />
to vaccinate the general population will enable practitioners to have these<br />
conversations with individual patients. Presenting evidence-based information and<br />
education within our patient community will provide a foundation for individuals<br />
to make the best decisions for their health and well-being as we all continue to<br />
navigate the COVID-19 pandemic.<br />
Reference:<br />
Centers for Disease Control and Prevention (<strong>2020</strong>). Talking to Patients about<br />
COVID-19 Vaccines. Downloaded from https://www.cdc.gov/vaccines/covid-19/<br />
hcp/talking-to-patients.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.<br />
gov%2Fvaccines%2Fhcp%2Fcovid-conversations%2Ftalking-to-patients.html<br />
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The President’s Message continued from page 1<br />
facts. Nurses have gained increased credibility during this crisis, and nurses' words<br />
may be meaningful and impactful to the public. This dissemination of facts could<br />
perhaps take the form of writing an editorial for your local newspaper – speaking<br />
to your experience with COVID-19 and the need for people to continue to protect<br />
themselves and others against the virus. We can stop now; even just talking about<br />
the facts of COVID-19 with relatives or friends can be powerful. It is hard to believe,<br />
but still, some people do not know or believe that wearing a mask, washing our<br />
hands, and social distancing are our best preventative weapons until, and maybe<br />
even after, nearly all <strong>Nevada</strong>ns become vaccinated against COVID-19. Sometimes we<br />
may look for grand interventions when simple things like educating our patients and<br />
the public may have a more significant effect.<br />
In addition to our role in educating about the virus, we can model the same behavior<br />
we extol. Just as our parents might have taught us, we need to ‘practice what we<br />
preach.' With the new spotlight that the pandemic has brought to nurses, others will<br />
look to us for advice, and our modeling of COVID-19 preventative behaviors is critical.<br />
I often wonder if we had modeling behaviors from our national leaders back in early<br />
<strong>2020</strong>, then maybe early 2021 might look different. Nevertheless, today is the situation<br />
we have, and looking forward may be more productive than recounting our past<br />
mistakes. Nurses can lead the way as we move through the new year.<br />
Looking forward to a promising future for all <strong>Nevada</strong>ns, I wish you and yours the<br />
best in the new year.<br />
Sincerely,<br />
Mary D. Bondmass, Ph.D., RN, CNE<br />
President, <strong>Nevada</strong> Nurses Association
<strong>December</strong> <strong>2020</strong>, January, February 2021 <strong>Nevada</strong> <strong>RNformation</strong> • Page 3<br />
Trickle Charge Your Self-Care During This Ongoing Crisis<br />
Sherry Stofko, MSN, RN<br />
Sherry practicing self-care in fresh air<br />
A few months ago, I wrote an article about<br />
how nurses were crumbling under the weight and<br />
uncertainty of the COVID outbreak. I asked that you<br />
give yourself “permission to fall apart.” Nurses were<br />
down back then, but we typically don’t stay down<br />
long. Has there been healing and growth since that<br />
time? In the mild “downtime” over the summer, did<br />
we use that time to build resilience and count our<br />
blessings? Did we restore our psychological reserves?<br />
Or did we waste time tallying our complaints against<br />
weak institutional leadership and governmental bodies,<br />
further eroding morale. Did healthcare administrators<br />
use that time to plan and prepare for COVID 2.0, AKA<br />
flu season PLUS an increase in coronavirus patients<br />
fueled by more indoor activities and large-scale political<br />
rallies? Seriously, it’s not like we didn’t know this wave<br />
was coming.<br />
Collectively, nurses are burning out in<br />
unprecedented numbers. Eight months of tough<br />
circumstances with little improvement will do that.<br />
We are sick of seeing our coworkers kept alive on<br />
ventilators. We can no longer bear to hold the cell<br />
phone while families cry their goodbyes to our intensive<br />
care patients. The smiles that used to soften our bad<br />
days are obscured by tattered, poorly sealing N95's<br />
that have been re-sterilized countless times since April.<br />
Nurses are generally empaths and people-persons who<br />
crave meaningful and unbridled relationships with<br />
friends, family, co-workers, patients, and patients’<br />
loved ones. The barriers of the face masks and<br />
restricted physical contact further the loss of human<br />
connection nurses so yearn for. To top it off, we are<br />
now getting crash courses in crisis standards of care,<br />
team nursing, disaster charting, and managing patients<br />
on ventilators.<br />
In the Spring and Summer, nurses felt dejected.<br />
Now, talking to nurses on the front lines, they express<br />
intense anger and frustration. They are “past the<br />
sadness,” as one colleague stated, and understandably<br />
so. Patients are incredibly ill. Units and hallways are<br />
full. Patient-to-nurse ratios are worsening an already<br />
intolerable situation. We're forced to work with<br />
strangers floated to our unit who are not experienced<br />
in our specialty and with whom we have no trusting<br />
relationship. We work in unfamiliar locations with<br />
equipment we’ve never seen before. Despite all this,<br />
we still hold ourselves to the highest standards and<br />
beat ourselves up when patient outcomes are less than<br />
stellar, and the guilt decimates our soul. We dutifully<br />
go back in for an extra shift, even though our crisis pay<br />
bonuses are shrinking as the pandemic lingers on. We<br />
complain about the staffing shortages, and when the<br />
organization brings in travelers, we complain about<br />
that as well.<br />
What I see as the biggest issue is the relentless<br />
feeling of anger fueled by being overwhelmed,<br />
disrespected, devalued, disempowered, silenced. I feel<br />
the same, and I no longer provide direct patient care.<br />
I hear the cries of the bedside nurses who tell similar<br />
stories: reusing single-use protective gear, supervisors<br />
who won’t replace unsafe masks, broken equipment<br />
not repaired. Many nurses who work in institutions<br />
that are not being honored with comparable crisis pay<br />
feel financially undervalued. Of course, hospital bottom<br />
lines have been hit hard by this pandemic, and millions<br />
of unbudgeted dollars have been spent on all sorts of<br />
items and staff. We know that healthcare institutions<br />
code for COVID and receive extra reimbursement<br />
for COVID patients and COVID-related projects. We<br />
ask, “Where is all this governmental funding going?”<br />
because it’s certainly not being funneled to the<br />
frontline staff working in the trenches, risking their lives<br />
and the safety of their families. Healthcare has never<br />
been so much a business as it is right now.<br />
What to do about all this? Even with vaccines on the<br />
way, we have a very long way to go in this pandemic.<br />
We use our cherished thirty-minute break to complain<br />
to and commiserate with staff about the horrible<br />
situation we’re in. We pick up extra shifts when our<br />
supervisors send the guilt texts about how the patients<br />
or our co-workers need us. We are banging our heads<br />
against the walls. We have virtually no control over<br />
corporate America, government, and big pharma who<br />
run this country’s healthcare system, so we need to<br />
take charge when and where we can.<br />
We do have control over our own thoughts,<br />
actions, and reactions. Many nurses are leaving the<br />
profession all together, tossing away their incredible<br />
skill set to start a craft business on Etsy. Uncountable<br />
healthcare workers are jumping ship and swimming<br />
over to the hospital across town or on the other side<br />
of the country. That other hospital is likely suffering the<br />
same woes because American healthcare is broken,<br />
not just your institution. The other facility may manage<br />
differently with seemingly better administrators and<br />
higher pay, but if we don’t have a handle on our own<br />
way of managing uncertainty, anger, and our feelings<br />
of being undervalued, we will find ourselves with the<br />
same complaints in a new setting six months from<br />
now. I wonder if all the people jumping on the travel<br />
nurse band wagon understand what they’re getting<br />
into. Having been a traveler from 1997 – 2006, I know<br />
very well the isolation, insecurity, incessant floating,<br />
bullying, and lack of support that comes with those fat<br />
paychecks. It’s not all rainbows and unicorns.<br />
What are the alternatives? How do we survive<br />
through this horrible pandemic and poor leadership?<br />
Building your resilience and prioritizing your self-care<br />
are paramount. Explore and practice ways to defuse<br />
your anger or respectfully direct it at the appropriate<br />
target. Start using your vacation time before mandatory<br />
overtime is instituted. Don’t answer the calls or read<br />
the texts on your off days. Exercise, stretch, meditate.<br />
Eat decent foods and treat yourself to the cupcakes<br />
now and then. Express gratitude. Tell your co-workers<br />
how valuable they are to you, and why. Try finding<br />
the silver lining; make a game of it. There must be<br />
something good about being floated from NICU to<br />
surgical-telemetry for 12.5 hours. Maybe it’s time<br />
to explore nursing positions in new specialties away<br />
from the bedside, far from the clutches of the Joint<br />
Commission, corporate, unsafe staffing matrices, and<br />
inadequate PPE. Most of the jobs outside direct patient<br />
care require higher levels of education, especially the<br />
ones that allow work from home. Academic degrees<br />
seem to be a huge divider in this, now more than<br />
ever. Maybe it’s time to seriously consider professional<br />
development and growth through programs such<br />
as Duke University’s Nurse Leadership Certificate or<br />
Grand Canyon University’s RN-to-BSN program. Is your<br />
head full of legitimate complaints about how poorly<br />
healthcare is run? Get involved politically or with your<br />
union, or you could write well-crafted letters to the<br />
<strong>Nevada</strong> Hospital Association.<br />
No matter how you choose to continue in your<br />
career, there’s no question it will be stressful, and the<br />
pandemic will be clouding our sunny skies for a while<br />
longer. Self-care with a focus on learning to handle<br />
recurrent adversities in a healthful way is vital. We<br />
bash administration for not properly planning for 2.0,<br />
but how well have you prepared? We don’t need a<br />
jump start on self-care; it’s too late for that. We need<br />
a trickle charge. What are you doing to trickle charge<br />
your health and wellness?
Page 4 • <strong>Nevada</strong> <strong>RNformation</strong> <strong>December</strong> <strong>2020</strong>, January, February 2021<br />
NNA'S CURRENT AND NEW MEMBERS!!<br />
Aaron Cook<br />
Aaron Bellow<br />
Abbie Purney<br />
Abbigail Holman<br />
Abigail Guevarra<br />
Adaobi Ezeanolue<br />
Aileen Thompson<br />
Akeisha King<br />
Alannah Bradley<br />
Alba Velasquez<br />
Alejandrina Diaz<br />
Alexandria Crossley<br />
Alexis Coe<br />
Alexis Walberg<br />
Aliah Metzger<br />
Alijandra Cruz-Tokar<br />
Alina Aidinova<br />
Alisa Patton<br />
Allison Saunders<br />
Allison Basta<br />
Alona Angosta<br />
Alonzo Thornton<br />
Althea Bongolan<br />
Alyssa Alden<br />
Amanda Stachlewitz<br />
Amanda Carpenter<br />
Amanda Frazier<br />
Amanda Berumen<br />
Amanda Tye<br />
Amanda Tobey<br />
Amanda Horton<br />
Amanda Gant<br />
Amanda Sweet<br />
Amanda Novick<br />
Amber Federizo<br />
Amie Ruckman<br />
Amy Hamtak<br />
Amy Bitto-Lange<br />
Amy Kunz<br />
Amy Runge<br />
Amy Sandstrom<br />
Amy Hollingshead<br />
Amy Cercone<br />
Amy Lelenko-Cain<br />
Amy Chaffin<br />
Amy Lynch<br />
Ana Rizzo<br />
Anastasia Ludel<br />
Andrea Travella<br />
Andrea Felesina<br />
Angela Holdridge<br />
Angela Turner<br />
Angela Mildon<br />
Angela Hurt<br />
Angela Brock<br />
Angela Amar<br />
Angela Shinoskie<br />
Anita Kuo<br />
Anna Apolonio<br />
Anna Anders<br />
Anna Smith<br />
Anna Marie Zamora<br />
Anne Wallace<br />
Anne Margaret Bexon<br />
Anne-Marie Schenk<br />
Annette Asbury<br />
Antionette Serrano<br />
Antoinette Carlos<br />
Antoinette Mullan<br />
Antonette Vergara<br />
Antonia McNamara<br />
April Sullivan<br />
April Daul<br />
April Hontanosas<br />
Ariana Johnston<br />
Ariana Monin<br />
Arkay Marie Lising<br />
Arlene Diaz<br />
Arlygen Ring<br />
Arvin Operario<br />
Ashley Akren<br />
Ashley Rhoades<br />
Ashley Swarowski<br />
Athelda Abrams<br />
Atheni Sevilla<br />
Aubree Carlson<br />
Audrey Hyland<br />
Audry See<br />
Autum Kapinkin<br />
Autumn Gardner<br />
Azeb Gebrekidan<br />
Barbara Barrett<br />
Barbara Parish<br />
Barbara Schneider<br />
Barbara Tanner<br />
Barbara Carlton<br />
Barbara Ruscingno<br />
Barbara Gross<br />
Beatrice Razor<br />
Beatrice Sanders<br />
Becky Czarnik<br />
Becky Tisue<br />
Beena Thomas<br />
Bernadette Sisnorio<br />
Bernadette Longo<br />
Beth Unger<br />
Beth Ennis<br />
Beth Hock<br />
Bethany Viglietta<br />
Bettina Alvarez<br />
Beverly Thielke<br />
Bobbi Shanks<br />
Bobbie Nemetz<br />
Bobette Ready<br />
Bonnie Carlisle<br />
Bonnie Spears<br />
Bonnie Glynn<br />
Brandee Shipman<br />
Brandi Jackson<br />
Brandie Oros<br />
Brandon Young<br />
Brandon Roberts<br />
Brandy Mebane<br />
Breanna Di Pinto<br />
Brenda Sanchez<br />
Brenda Kaczmarek<br />
Brenda Bien<br />
Brenda Delgado<br />
Brenda Harding<br />
Brian Gotiangco<br />
Brian Hubbard<br />
Brittney Allen<br />
Byron Ricana<br />
Camella Stephens<br />
Cameron Duncan<br />
Cami Carr<br />
Camilla Camburn<br />
Candace Grubb<br />
Candace Facio<br />
Candace Camelon<br />
Candice Hamel<br />
Carina Deras<br />
Carla Baizas<br />
Carlota Cinco<br />
Carmelita Macayan-Hicks<br />
Carol Vickrey<br />
Carol Rose<br />
Carol Swanson<br />
Carol Panknin<br />
Carol Kutz<br />
Carol Mancilla<br />
Caroline Devano<br />
Carolyn Sabo<br />
Carrie Hintz<br />
Casey Peay<br />
Cassandra Trummel<br />
Catherine Ferguson<br />
Catherine Gonzalez<br />
Catherine Dellinger<br />
Catherine Dinauer<br />
Catherine Fuller<br />
Cathy Fry<br />
Cathy Downey<br />
Cathy Adams<br />
Cecelia Fernan<br />
Cecilia Fleming<br />
Celia Lamdagan<br />
Celine Cinq<br />
Chamonix McElliott<br />
Chandra King<br />
Charina Mae Picornell<br />
Charissa Sheppeard<br />
Charlice Barrett<br />
Charlton Lovett<br />
Chasity Rodrigues<br />
Chelsea Dague<br />
Chelsea Takara<br />
Chere Gooch-Martin<br />
Cherie Dimaguila<br />
Cherilyn Campbell<br />
Cherry Grace Daelto<br />
Cheryl Martin<br />
Cheryl Lake<br />
Cheryl Dela Cruz<br />
Cheryl Broussard<br />
Chiline Tan-Birket<br />
Christa Secord<br />
Christal Kercheval<br />
Christelle Tchouanang<br />
Christi Keliipio<br />
Christina McGuire<br />
Christina Dyer<br />
Christina Weinrick<br />
Christine Obregon<br />
Christine Windle<br />
Christine Sterrett<br />
Christine O'Brien<br />
Christine Pebbles<br />
Christine Barnett<br />
Christopher Rice<br />
Christy Raynes<br />
Christy Pacini<br />
Chrystine Revelli<br />
Chukwuemeka Obilor<br />
Chyann Porterfield<br />
Ciara Richman<br />
Cindi Freeborn<br />
Cindy Merkley<br />
Cindy Ramiscal<br />
Clare Parkinson<br />
Clarisse Manabat<br />
Clarizza Tamayo<br />
Claudia Buco<br />
Clem Victor Manrique<br />
Connie Evans<br />
Connie Ngo<br />
Conrado Yutuc<br />
Constance Petronella<br />
Constanza Bridges<br />
Cori Ward<br />
Corine Watson<br />
Corrine Pace<br />
Crishiell Calina<br />
Crista Mae Therese<br />
Yamomo<br />
Cristina Mosqueda<br />
Cristy Thomas<br />
Crystal Martinez<br />
Cynthia Sitar<br />
Cynthia Fuentes<br />
Cynthia Brandt<br />
Cynthia Davis<br />
Cynthia Morris<br />
Cynthia Gorham<br />
Cynthia Privitera<br />
Cynthia Veal<br />
Cynthia Repella-Allen<br />
Cynthia Parker<br />
Cynthia Lewis<br />
Dahlia Dixon<br />
Daisy Milan<br />
Daisy Medrano<br />
Damiana Choi<br />
Dana Soma<br />
Daniella Kinyua<br />
Danielle McVickers<br />
Danielle Evans<br />
Danielle Smith<br />
Danielle Planas<br />
Danielle Norris<br />
Danijela Cakovic<br />
Dao Huynh<br />
Darius Thompson<br />
Darlene Salvo<br />
Darnell Caldwell<br />
Dave Tyrell<br />
David Alvarez<br />
David Troy<br />
Dawn Lipkin<br />
Dawn Cook<br />
Dawn Taylor<br />
Dawn Judman<br />
Dawn Elton<br />
Deanna Schouten<br />
Debi Ingraffia-Strong<br />
Deborah Ain<br />
Deborah Sanborn<br />
Deborah Carrabello<br />
Deborah Miller<br />
Debra Minagil<br />
Debra Toney<br />
Debra Robison<br />
Debra Scott<br />
Debra Bennett<br />
Debra Ruiz<br />
Debra Fredericks<br />
Demetria Smith-Jordan<br />
Denis Williams<br />
Denise Horvath<br />
Denise Rawson<br />
Denise Dorsa<br />
Denise Rowe<br />
Denise Ortega<br />
Denisha Lang<br />
Desiree Crawford<br />
Destiny Lacefield<br />
Diana Brandes<br />
Diane McGinnis<br />
Diane Hughes<br />
Diane Paugh<br />
Dianne Bulanadi<br />
Dina Alzadon<br />
Dinah Lynn Sinang<br />
Dino Brozan<br />
Dionneshele Fears<br />
Dolores Sangiuliano<br />
Dominique Corbine<br />
Dona Rivera<br />
Donna Mattson<br />
Donna Wirthlin<br />
Donna Shiffer<br />
Donna Sandie<br />
Donna Green<br />
Donna Wollman<br />
Doretha Smith<br />
Dorita Sondereker<br />
Dorothy Adams<br />
Dorothy Reynolds<br />
Dorthia Daudier<br />
Douglas Turner<br />
Dr. Remeliza Tukay<br />
Draven Martinez<br />
Ebony Balele<br />
Eden Hicks<br />
Edna Dela Cruz<br />
Eghosa Odobo<br />
Eireen Dumlao<br />
Elaine Peneyra<br />
Elaine Clore<br />
Eldann Galacgac<br />
Elena Ellen Maborang<br />
Elisabeth Higgins<br />
Eliza Fountain<br />
Elizabeth Fildes<br />
Elizabeth Chau<br />
Elizabeth Cogan<br />
Elizabeth Brox<br />
Elizabeth Tissier<br />
Elizabeth Carrasco<br />
Elizabeth Dotson<br />
Elizabeth Kelemen<br />
Elizabeth Green<br />
Elizabeth Solomon<br />
Elizabeth Temean<br />
Elizabeth Wilkes<br />
Eljena Peterson<br />
Ellaine Alvarez<br />
Ellen Williams<br />
Ellen Deprat<br />
Ellen M. Lewis<br />
Elsie Jimenez<br />
Emelie Grady<br />
Emerald Heldt<br />
Emily Zuch<br />
Emily Sharpe<br />
Emily Darling<br />
Emily Hannemann<br />
Emily Brown<br />
Emlyn Escobar<br />
Emmanuel Umunnakwe<br />
Enrica Lumapas<br />
Erica Daniels<br />
Erickia Thompson<br />
Erin Gostin<br />
Erin Grable<br />
Erin Taranto<br />
Erin Sandoval<br />
Erin Miyashiro<br />
Esmeralda Clark<br />
Esther Katz-Willson<br />
Eunice Ugochukwu<br />
Eunsung Kim<br />
Eva Maria Rivera<br />
Evangeline Gallagher<br />
Evelyn Lundell<br />
Evelyn Bruner<br />
Fatimah Tripathi<br />
Fatina McNeil-Pitts<br />
Felicia Haywood<br />
Felicia Talamante<br />
Felicidad Taduran<br />
Flora Sayson<br />
Flordelis Delacruz<br />
Frances Meyer<br />
Frances Dacquisto-Sloan<br />
Francis Torres<br />
Franklin Manas<br />
Gabrielle Peterson<br />
Gail McGuill<br />
Gail Rattigan<br />
Gamaliel Digan<br />
Geneva Watkins<br />
Genica Gelson<br />
Genoa Vaughn<br />
Geoconda Hughes<br />
Gershon Bernal<br />
Geselle Corpuz<br />
Gina Johnson<br />
Gina Orr<br />
Ginger Faye Flores<br />
Gisela Flores<br />
Gladys Easterling<br />
Glenn Hagerstrom<br />
Gloria Castillo<br />
Gloria Williams<br />
Gloria Means<br />
Gloria Mandel<br />
Grace Hills<br />
Greela Joy Yadao<br />
Gregory Walters<br />
Greny Maliakal<br />
Greta Mann<br />
Greta Castro<br />
Haley Schwade<br />
Hannah Kohler<br />
Haydee Jeanette Nuno<br />
Hea Won Lee<br />
Heather Bonny<br />
Heather Gingell<br />
Heather Arch<br />
Heather Lopez<br />
Heather McIntyre<br />
Heather Sabol<br />
Heather Spaulding<br />
Hedian Swanson<br />
Helen Opdyke<br />
Helmi Olsen<br />
Hilda Pool<br />
Hillarie Lara<br />
Holly Pelka<br />
Homer Tuazon<br />
Ilene Hobson<br />
Iliana Britt<br />
Ingela Hadad<br />
Ingrid Rivera<br />
Ivonne Cruz<br />
Jackie Chapman<br />
Jackie Alexander<br />
Jacqueline Hartert<br />
Jacqueline Crittendon<br />
Jacqueline Ladanga<br />
Jacqueline Wenceslao<br />
Jacqueline Jeffery<br />
Jacquelyn Niesen<br />
Jacquese Simpson<br />
Jaime Young<br />
Jama DeYoe<br />
Jamie Lewis<br />
Jan Pennington<br />
Jan Michael Arceo<br />
Jana Nerz<br />
Jane Sadorra<br />
Jane Horth<br />
Janecein Amadi<br />
Janee Elliott<br />
Janelle Willis<br />
Janelle Kyles<br />
Janet Bryant<br />
Janet Leinen<br />
Janet Ford<br />
Janet Handley<br />
Janet Purcell Gray<br />
Janice Robert<br />
Janice Owens<br />
Janice Iida<br />
Janice Muhammad<br />
Jannette Balderrama<br />
Jasmin San Luis<br />
Jasmin Matutis<br />
Jasmine Mielnik<br />
Jason McKinney<br />
Jay Bondoc<br />
Jayanthi Henry<br />
Jayson Paulo Agaton<br />
Jazmyn Duncan<br />
Jean Zlomke<br />
Jean Lyon<br />
Jeanette Lambdin<br />
Jeanette Sivon<br />
Jeanne Reeves<br />
Jeannine Clark<br />
Jeffrey Whetstone<br />
Jemia Martin<br />
Jenifer Krause<br />
Jenifer Enriquez<br />
Jenna Clark<br />
Jennie Supple<br />
Jennifer Mahlberg-Grant<br />
Jennifer Pfannes<br />
Jennifer Obieta<br />
Jennifer Archuleta<br />
Jennifer Shearer<br />
Jennifer Brown<br />
Jennifer Finley<br />
Jennifer Han<br />
Jennifer Roy<br />
Jennifer Vernon-<br />
Gonzalez<br />
Jennifer Morris<br />
Jennifer Padilla<br />
Jennifer Miceli<br />
Jennifer Abordo<br />
Jennifer Gilligan<br />
Jennifer Kawi<br />
Jennifer Strawn<br />
Jennifer Harrington<br />
Jennifer Millet<br />
Jennifer Landberg<br />
Jenny Kelly<br />
Jeremy Friend<br />
Jerrilynn Woolston<br />
Jessamine Gale Pantig<br />
Jessica Povey<br />
Jessica Bliven<br />
Jessica Danyan<br />
Jessica Harbauer<br />
Jessica Richard<br />
Jessica Valle<br />
Jessica McIntosh<br />
Jessyca Luke<br />
Jesus V Cornelio Catre<br />
Jhouleen Angelika<br />
Tiamzon<br />
Jiaqing Li<br />
Jinyoung Kim<br />
Joann Nardoni<br />
Joann Bruno<br />
Joann Rupiper<br />
Joanna Valdes<br />
Joanna Patrice Johnson<br />
Joanne Cretney-Tsosie<br />
Jodi Epp<br />
John Coldsmith<br />
Jon Arlien<br />
Jon Failla<br />
jonda Purper<br />
Jordan Carley<br />
Jordana Janjua<br />
Jordyn Belli<br />
Joseph Armbruster<br />
Joseph Barnes<br />
Joseph Taylor Jr<br />
Joy Patrick<br />
Joy Gombeda<br />
Joy Banzon-Villamora<br />
Joyce Walters<br />
Joyce Tabios<br />
Joyce Damiano<br />
Juancho Trinidad<br />
Juanita Jones<br />
Judith Hochberger<br />
Judy Ward-Bzoskie<br />
Judy Araque<br />
Julia Somerville-Reeser<br />
Julia Olson<br />
Julia Oleary<br />
Julie Johnson<br />
Julie Faulkner<br />
Julie Bassett<br />
Julie Fitzgerald<br />
Julie Worman<br />
Julie Kewanyama<br />
Julius Caezar Henzon<br />
K. Lynberg<br />
Kaela Friedman<br />
Kaitlyn Cummings<br />
Kalita Silvestre<br />
Karen Meskimen<br />
Karen Eisenberg<br />
Karen Lanham-Evans<br />
Karen Bearer<br />
Karen Valdez<br />
Karen Laux<br />
Karen Edwards<br />
Karen Anne Wolfe<br />
Karen Marie Beardsley<br />
Kari Schleidt<br />
Karisa Son<br />
Karma Florence<br />
Katelyne May Atijera<br />
Katherine Kauble<br />
Katherine Visman<br />
Katherine Franco<br />
Katherine Vernetti<br />
Kathleen Mohn<br />
Kathleen Zaski<br />
Kathryn Schaller<br />
Kathryn Moran<br />
Kathryn Tickell<br />
Kathy Webb<br />
Kathy Goldsworthy<br />
Katie Bomberger<br />
Katie Green<br />
Katrina Perkins Davis<br />
Katylynn Hymas<br />
Kayla Edwards<br />
Kayla McMillen<br />
Keiona Malone<br />
Kelli Wray<br />
Kelly Mecham<br />
Kelly Bucalo<br />
Kelly Sinkovec<br />
Kelly Thompson<br />
Kelly Morrow<br />
Kelly Jane Villaroman<br />
Keri Piper-Colonna<br />
Killeen Bell<br />
Kim Griffin<br />
Kimberlee Bliek<br />
Kimberly Falco<br />
Kimberly Kandt<br />
Kimberly Cathcart<br />
Kimberly Simpson<br />
Kimberly Maribbay<br />
Kintana Wixom<br />
Kirsten Landis<br />
Kristen Grunerud<br />
Kristie Meacham<br />
Kristienne Porter<br />
Kristin Hayden<br />
Kristin Gillman<br />
Kristina Spitale-Efstratis<br />
Kristina Tischler<br />
Kristine Coleman<br />
Kristine Hafner<br />
Kristyn Cisilino<br />
Kylie Lewis<br />
Lajuana Derico<br />
Lanette Kimmel<br />
Lara Carver<br />
Lara Morales<br />
Larissa Africa<br />
Lashawna Franklin<br />
Latricia Perry<br />
Lattrice Dickson<br />
Launa Curtis<br />
Laura Harsh<br />
Laura Martin<br />
Laura Czajkowski<br />
Lauren Tolentino<br />
Laurice Jones<br />
Laurie Walker<br />
Lavon Elias-Jones<br />
Layne Sellars<br />
Lea Pauley<br />
Leah Churchill<br />
Leah Delim<br />
Leah Gaitho<br />
Lee Anna Bristol<br />
Leidy Chavez-Guzman<br />
Leigh Bohn<br />
Leigh-Ann Biggs<br />
Leila Cruz-Aguon<br />
Leila Romero<br />
Lenette Mapes<br />
Leona Munro<br />
Leslee Bridget Magnus<br />
Leslie Decrona<br />
Leslie Simmons<br />
Leti Guerra-Scheib<br />
Leticia Faust<br />
Lia Harris<br />
Linda Zahrt<br />
Linda Bowman<br />
Linda Silvestri<br />
Linda Jacks<br />
Linda Andrews<br />
Linda Rittenburg<br />
Linda Banks<br />
Lindsey Butcher<br />
Lindsey Enriquez<br />
Lindsey Wharton<br />
Linetta Barnes<br />
Lisa Dinwiddie<br />
Lisa Thomas<br />
Lisa Eldridge-Murphy<br />
Lisa Dunkelberg<br />
Lisa Brown<br />
Lisa Todd<br />
Lisa Schaffer<br />
Lisa Engleman<br />
Lisa Marie Pacheco<br />
Lloyzel Faye Yung<br />
Lordlita Wirtz<br />
Lori Roorda<br />
Lori Eustis<br />
Lori Baumann<br />
Lori Marhanka<br />
Lori Candela<br />
Lorraine Noonan<br />
Lorraine Bonaldi<br />
Lorri Lantz<br />
Luis Vidana<br />
Luis Rodriguez<br />
Luz Aragon<br />
Lynn Licastro<br />
Lynn Taylor<br />
Lynn Von Schlieder<br />
Ma Renzel Therezna<br />
Caparros<br />
Mackenzie Butler<br />
Maddalena Fontein<br />
Mae Nekoba<br />
Maelaurece Plaza-Cross<br />
Magdalena Rodriguez<br />
Malcolm Aquino<br />
Manasseh Chibwe<br />
Maquette Thompson<br />
Marcie Zajac<br />
Marco Cerda<br />
Marena Works<br />
Margaret Louis<br />
Margaret Calavan<br />
Margaret Sanger<br />
Margaret Covelli<br />
Margo Baxter<br />
Maria Elario
<strong>December</strong> <strong>2020</strong>, January, February 2021 <strong>Nevada</strong> <strong>RNformation</strong> • Page 5<br />
Maria Sampang<br />
Maria Amezcua-Huerta<br />
Maria Angela Nina Vela<br />
Maria Concepcion<br />
Benito-Spero<br />
Maria Gina Agnir<br />
Maria Mernina April<br />
Montero<br />
Maria Monica Aragon<br />
Maria Nica Diez<br />
Maria Rizel Sturgell<br />
Maria Rosario Wood<br />
Marian Gnandt<br />
Maribel Gomez<br />
Maribel Cabulang<br />
Maricel Olan<br />
Marie Luback-Neves<br />
Marie Reyrao<br />
Marie Snook<br />
Marife Aczon-Armstrong<br />
Marilyn Getty<br />
Marisa Wilkinson<br />
Marisa Leah Dela Rosa<br />
Marisela Castorena<br />
Marites Molina-Matro<br />
Marizel Yukee<br />
Marjorie Adams<br />
Marjorie Von Nordeck<br />
Mark Ferratt<br />
Markeeta Araujo<br />
Markita Griffin<br />
Marlene Kramer<br />
Marphyrose Galang<br />
Marsha Park<br />
Martha Hobby<br />
Martha Drohobyczer<br />
Mary Mackenzie<br />
Mary Courtney<br />
Mary Bondmass<br />
Mary Field<br />
Mary Manoharan<br />
Mary Jingeleski<br />
Mary Headley<br />
Mary Whitield<br />
Mary Huntly<br />
Mary Flint<br />
Mary McConville<br />
Mary Reed<br />
Mary Foster<br />
Mary Denisse Toribio<br />
Mary Grace Del Rosario<br />
Maryangelique Sampson<br />
Maureen Barnes<br />
Maureen Nolen<br />
Maureen Scott-Feagle<br />
Mavirginia Espanol<br />
Maya Washington<br />
Maylene Culanag<br />
Meg Hopper<br />
Megan Remien<br />
Megan Gates<br />
Megan Gill<br />
Megan Martinez<br />
Meia Ford<br />
Meilan Daguman<br />
Melanie Lunghi<br />
Melanie Lentz<br />
Melba Schwinghamer<br />
Melisa Smith<br />
Melissa Ridella<br />
Melissa Dorman-Ellis<br />
Melissa Washabaugh<br />
Melissa Cook<br />
Melissa Rosales<br />
Melody Talbott<br />
Melody Tulloss<br />
Mercedes Ocan<br />
Merete Egloff<br />
Merle Williams<br />
Mi’Lan Jones<br />
Michael McEvoy<br />
Michael Bass<br />
Michael Cabaccang<br />
Michael Yazinka<br />
Michael Loehr<br />
Michael Basinger<br />
Michael Cowles<br />
Michele Rath<br />
Michele Arce<br />
Michele Wijangco<br />
Michele (Shelly) Alfaro<br />
Michelle Dunne<br />
Michelle Bland<br />
Michelle Dix<br />
Michelle Tompkins<br />
Michelle Albaran<br />
Michelle Sarvela<br />
Michelle Wagner<br />
Michelle Podlesni<br />
Michelle Reynolds<br />
Mika Martin<br />
Mindy Triola<br />
Miriam Volpin<br />
Mojisola Balogun<br />
Mona Beerbower<br />
Moneshia Perkins<br />
Monica Ranada<br />
Monika Asamaphand<br />
Monty Gross<br />
Myla Daigeau<br />
Myra Davis-Alston<br />
Myra Tomas<br />
Nadia Luna<br />
Nanci Quinn<br />
Nancy Bartlett<br />
Nancy Legaspina<br />
Nancy Gubler<br />
Nancy Brewster-Meredith<br />
Naomi Lazore Edwards<br />
Nasim Akbari<br />
Natasha Tretheway<br />
Nathan Fowler<br />
Nathifa Charles<br />
Nayeli Melendez<br />
Nelly De Dios<br />
Nemia Chiang<br />
Ngozi Ajiri<br />
Nicholas Muir<br />
Nichole Fritel<br />
Nicola Aaker<br />
Nicole Caturay<br />
Nicole Gooden<br />
Nicole Courts<br />
Nicole Carr<br />
Nicole Hunt<br />
Nicole Gregorio<br />
Nicole Vaughn<br />
Nicole Miskiewicz-Nelson<br />
Nobuko Wallace<br />
Nonette Chee<br />
Noni Hayman<br />
Norah Lusk<br />
Norman Wright<br />
Nubia Garbutt<br />
Nutchar Ploymee<br />
Odessa Gregorio<br />
Ofelia Esguerra<br />
Ogonnaya Onyema<br />
Okechukwu Olisa<br />
Olga Bienvenue<br />
Oluyemisi Adedotun<br />
Omana Olickal<br />
Pamela Johnson<br />
Pamela Adzima<br />
Pamela Guerra<br />
Pamela Burnley<br />
Pamela French<br />
Patrice Gallagher<br />
Patricia Crepps<br />
Patricia Fries<br />
Patricia Strobehn<br />
Patricia Prevosto<br />
Patricia Busch<br />
Patricia Brown<br />
Patricia Alpert<br />
Patricia Correll<br />
Patricia Simmers<br />
Patrick Bucayu<br />
Paula Williams<br />
Peggie Black<br />
Peggy Ince<br />
Peggy Lee<br />
Peggy Kamper<br />
Perla Labastida Espejel<br />
Petal Codrington-Martial<br />
Precious Achuff<br />
Priscilla Nelson<br />
Priscilla Austin<br />
R Danessa Rebello<br />
Rachel Likes<br />
Rachel Juell<br />
Rachel Michaels<br />
Rachel Moore<br />
Rachell Ekroos<br />
Rachell Anne Agas<br />
Ramona Chatman<br />
Rannie Deguzman<br />
Raquel Welsh<br />
Rebecca Black<br />
Rebecca Gansberg<br />
Rebecca Roleff<br />
Rebecca Pierce<br />
Rebecca Graham<br />
Rebecca Thomas<br />
Rebecca Cormier<br />
Rebecca Hayslett<br />
Reginald Reyrao<br />
Reina Alarcon<br />
Remedios Jallorina<br />
Renate Jeddahlyn Flores<br />
Rene Wood<br />
Renee Villarruel<br />
Renee Page<br />
Renee Hinojosa<br />
Renee Todd<br />
Rhea Bautista<br />
Rhigel Tan<br />
Rhonda Strunk<br />
Rica Martin<br />
Rica Santa Maria<br />
Rich Janel Suanes<br />
Richard Becker<br />
Rita Siu<br />
Rizza Marie Tawatao<br />
Robert Lopez<br />
Robert Welch<br />
Robert Fox<br />
Robert Erickson<br />
Robert Briseno<br />
Robin Hoover<br />
Robin Branham<br />
Roderick Gipson<br />
Roger Patricio<br />
Roland Villareal<br />
Rona Yee<br />
Rona Divinagracia<br />
Ronnie Bordador<br />
Rosalba Renteria<br />
Rosalyne Reynolds<br />
Roscelle Jhoyce Minoza<br />
Rose Hettinga<br />
Roseann Colosimo<br />
Rosemary Witt<br />
Rosemary Gharibian<br />
Rosemary Thuet<br />
Roshele Ward<br />
Rowena Mananquil<br />
Rowena Dioquino<br />
Ruth Politi<br />
Sabina Grimes<br />
Sabrina Bratcher<br />
Sally Jost<br />
Sally Adams<br />
Samantha Jones<br />
Samantha Thornton<br />
Samantha Chanel De<br />
Vera<br />
Samantha-Rose Threats<br />
Sandra Turner<br />
Sandra Rodriguez<br />
Sandra Talley<br />
Sandra Doolin<br />
Sandra Pierre-Louis<br />
Sara Maul<br />
Sara McKnight<br />
Sarah Moore<br />
Sarah Linaman<br />
Sarah Johnson<br />
Sarah Webb<br />
Sarah Herbert<br />
Sarah McCalden<br />
Sarah Maciolek<br />
Sarah Bussmann<br />
Sarah Rose Nelson<br />
Saundra Hart<br />
Savalla McLeod<br />
Schlene Peet<br />
Selina Rivera<br />
Shaheen Ahmad<br />
Shana Blakely<br />
Shannon Murray<br />
Shannon Grella<br />
Shannon Chartrey<br />
Sharean Oxley<br />
Sharon Freier<br />
Sharon Szeman<br />
Sharon Mann<br />
Sharon Attaway-Hett<br />
Sharon Oetting<br />
Shasta Taylor<br />
Shaun Hasty<br />
Shaunta Brown<br />
Shawn Deal<br />
Shawn Joseph<br />
Shawna Senart<br />
Sheery Villagracia<br />
Sheila Parker<br />
Sheimon Capiendo<br />
Shelby Temple<br />
Shelia Bien<br />
Shelly Nicola<br />
Shelly Soto<br />
Sheri Park<br />
Shermeka Tubbs<br />
Sheron Williams-Nevens<br />
Sherri Lindsey<br />
Sherri Yagoubi<br />
Sherri Howell<br />
Sherrian Miles<br />
Sherrie Olson<br />
Sherry Stofko<br />
Sheryl Bennett<br />
Shirin Nazarian<br />
Shirley Caldwell-Butts<br />
Skyler Basanez<br />
Sonia Wyatt-Wright<br />
Loneliness and Social Isolation<br />
Cause Emotional Pain in the Elderly<br />
Sonja Poppenhagen<br />
Sonja Mann<br />
Sophia Student<br />
Sorah Chung<br />
Stacey Earley<br />
Stacey Hunt<br />
Stacey Lea Spahn<br />
Staci Thompson<br />
Stacy Springgate<br />
Stacy Rust<br />
Stacy Thaler<br />
Stacy Wilson<br />
Stacy Demitropoulos<br />
Starla Ricks<br />
Stefny Cabrera<br />
Stephanie Latta<br />
Stephanie Parker-Hyman<br />
Stephanie Prather<br />
Stephanie Crim<br />
Stephanie Curry<br />
Stephanie Herrera<br />
Stephanie Guerrero<br />
Stephanie Melcher<br />
Stephanie Neder<br />
Stephen Lester<br />
Steven Knott<br />
Susan Hubbard<br />
Susan Becker<br />
Susan VanBeuge<br />
Susan Growe<br />
Susan Ervin<br />
Susan Englen<br />
Suzann Gordon<br />
Suzanne Dessaints<br />
Suzanne Elnagar<br />
Sylvia Fernandez<br />
Tabbly Taylor<br />
Tamara Duff<br />
Tamara Mette<br />
Tamasha Benson<br />
Tamera Allred<br />
Tami Beckett<br />
Tammam Whalen<br />
Tammy Bambic<br />
Taneya Wills<br />
Tanya Liscio<br />
Tara Alcid<br />
Tendai Gombe-Lane<br />
Teresa Mercado<br />
Teresa Praus<br />
Terri Vinson<br />
Terry Stanley<br />
Thelma Pacheco<br />
Theophilus Akoh<br />
Theresa Gordon<br />
Theresa Spina<br />
Theresa Brown<br />
Theresa Carr<br />
Therese Rohling<br />
Tiffani Lenzi<br />
Tiffany Febre<br />
Tiffany Ramirez<br />
Tiffany Vincent<br />
Tiffany Yohey<br />
Tiffiny Cicero<br />
Tina Procter<br />
Todd D'Braunstein<br />
Todd Erickson<br />
Todd Isbell<br />
Tomas Walker<br />
Toni Orr<br />
Tonya Bryant<br />
Tori Davis<br />
Toya Lewis<br />
Tracey McCollum<br />
Tracey Silva<br />
Tracey Johnson-Glover<br />
Tracie Gust<br />
Tracy Harig<br />
Trevelyn Gray<br />
Trina Hammond<br />
Trinette Broom<br />
Tristen Wydeman<br />
Trixia Mora<br />
Tymeeka Davis<br />
Tysha Jones<br />
Valan Kam<br />
Valeria Melendez Estrada<br />
Valerie Jakubos<br />
Valerie Castaneda<br />
Vanessa Obando<br />
Vanessa Parker<br />
Vanessa Izquierdo<br />
Vera Sverdlovsky<br />
Veronica Dunn-Jones<br />
Veronica Brady<br />
Veronica Niki James<br />
Vicki Walker<br />
Vicki Wolms<br />
Vickie McPherson<br />
Vicky Lang-Catlin<br />
Victoria Volz<br />
Virginia Enns<br />
Virginia Williamson<br />
Virginia Hayes<br />
Visminda Tagbo<br />
Vivian Smith<br />
Wanda Sheppard<br />
Wanda Macfarlane<br />
Wanesa Yuhmo<br />
William Macaraig-Organ<br />
Winnie Chua<br />
Xandee Shirley Bernabe<br />
Xenia Daffodil Valles<br />
Yarleny Roa-Dugan<br />
Yashmine Ballesteros<br />
Yvette Medlin<br />
Yvonne Anderson<br />
Yvonne Modarres<br />
Zachary Bunker<br />
Zachary Ashton<br />
Zhuoya Mai<br />
Karra Harrington and Martin J. Sliwinski<br />
** This article was published in The Conversation, a<br />
free on-line newsletter. “We believe in the free flow of<br />
information. Republish our articles for free, online or<br />
in print, under a Creative Commons license.” Read the<br />
newsletter at www.theconversation.com<br />
Maintaining high quality relationships may be a key<br />
for protecting brain health from the negative impacts<br />
of loneliness. The loneliness of social isolation can<br />
affect your brain.<br />
Physical pain is unpleasant, yet it’s vital for survival<br />
because it’s a warning that your body is in danger. Pain<br />
tells you to take your hand off a hot burner or to see a<br />
doctor about discomfort in your chest. Pain reminds us<br />
all that we need to take care of ourselves.<br />
Feeling lonely is the social equivalent to feeling<br />
physical pain. It even triggers the same pathways in<br />
the brain that are involved in processing emotional<br />
responses to physical pain.<br />
Just like feeling physical pain, feeling lonely and<br />
disconnected from others is also a signal that we<br />
need to take care of ourselves by seeking the safety<br />
and comfort of companionship. But what happens<br />
when we are unable to find companionship and the<br />
loneliness persists?<br />
As scholars at the Center for Healthy Aging at Penn<br />
State, we study the impact of stress on the aging<br />
body and brain, including how it can worsen cognitive<br />
decline and risk for dementia. The social isolation older<br />
adults are experiencing now amid the coronavirus<br />
pandemic is raising new mental health risks, but there<br />
are things people can do to protect themselves.<br />
The health consequences of loneliness<br />
The COVID-19 pandemic has put many older<br />
adults’ social lives on hold, leaving them at greater risk<br />
for loneliness. They know they face a higher risk of<br />
developing severe symptoms from COVID-19, so many<br />
are staying home. Restaurant closures and limits on<br />
visitors to assisted living centers have made it harder to<br />
see family and friends.<br />
But even prior to the pandemic, public health<br />
experts were concerned about the prevalence and<br />
health impacts of loneliness in the U.S. Loneliness<br />
affects between 19% and 43% of adults ages 60 and<br />
older, and many adults ages 50 and over are at risk of<br />
poor health from prolonged loneliness.<br />
Research has shown that prolonged loneliness is<br />
associated with increased risk for premature death,<br />
similar to smoking, alcohol consumption and obesity.<br />
Other health consequences are also associated with<br />
loneliness, including elevated risk for heart disease and<br />
stroke, and it is associated with increased physician<br />
visits and emergency room visits.<br />
Loneliness can affect brain health and mental<br />
sharpness<br />
Older adults who are socially isolated or feel<br />
lonely also tend to perform worse on tests of<br />
thinking abilities, especially when required to process<br />
information rapidly.<br />
Moreover, those who feel lonely show more rapid<br />
decline in performance on these same tests over several<br />
years of follow-up testing.<br />
It is thought that loneliness may contribute to<br />
cognitive decline through multiple pathways, including<br />
physical inactivity, symptoms of depression, poor sleep<br />
and increased blood pressure and inflammation.<br />
Loneliness has also been found to increase the risk<br />
of developing dementia by as much as 20%. In fact,<br />
loneliness has an influence similar to other more wellestablished<br />
dementia risk factors such as diabetes,<br />
hypertension, physical inactivity and hearing loss.<br />
Although the underlying neural mechanisms are<br />
not fully understood, loneliness has been linked with<br />
the two key brain changes that occur in Alzheimer’s<br />
disease: the buildup of beta-amyloid and tau proteins<br />
in the brain. Other indicators of psychological distress,<br />
such as repetitive negative thinking, have also be<br />
linked with the buildup of beta-amyloid and tau in<br />
the brain. Theories suggest that loneliness and other<br />
psychological stressors act to chronically trigger the<br />
biological stress response, which in turn appears to<br />
increase beta-amyloid and tau accumulation in the<br />
brain.<br />
How loneliness can contribute to disease<br />
The evidence suggests that prolonged feelings of<br />
loneliness are detrimental to health. So, how do those<br />
feelings get converted into disease?<br />
Loneliness and Social Isolation...continued on page 12
Page 6 • <strong>Nevada</strong> <strong>RNformation</strong> <strong>December</strong> <strong>2020</strong>, January, February 2021<br />
Research & EBP Corner<br />
Tranquility Rooms and Stress Reduction<br />
Submitted by<br />
Mary Bondmass, Ph.D., RN, CNE<br />
This RNF feature presents abstracts of research and<br />
evidence-based practice (EBP) projects completed or<br />
spearheaded by nurses or student nurses in <strong>Nevada</strong>.<br />
The focus is on new evidence (i.e., research) or on the<br />
translation of evidence (i.e., EBP) in Practice, Education,<br />
or Research. Submissions are welcome and will be<br />
reviewed by the RNF editorial board for publication;<br />
send your abstract submission in a similar format used<br />
below to mary.bondmass@unlv.edu<br />
Michelle McGrorey, BSN, RN, OCN, HTCP, NCCA,<br />
HNB-BC, HMIP and Deborah McKinney, BSN, RN, HMIP<br />
took first place honors at the recent 3rd Annual UMC<br />
Research Empowerment Day in the Completed Clinical<br />
Project Category. Michelle and Debbie’s research<br />
focused on the use of Tranquility Rooms to reduce staff<br />
stress at University Medical Center of Southern <strong>Nevada</strong>.<br />
Their picture, abstract and poster are below.<br />
Michelle McGrorey, BSN, RN, OCN, HTCP, NCCA,<br />
HNB-BC, HMIP and<br />
Deborah McKinney, BSN, RN, HMIP<br />
Background:<br />
Jobs in the healthcare industry are among the most<br />
stressful in the U.S. Work hours, burn-out, compassion<br />
fatigue, overtime, and conflict make self-care difficult.<br />
Lack of self-care can render any health care worker<br />
ineffective on the job. In a hospital setting, quiet rooms<br />
are playing a critical role in mitigating severe and/or<br />
overwhelming stress often experienced by staff during<br />
shifts that exhaust emotional and mental reserves.<br />
Quiet rooms have been shown to promote well-being<br />
and resiliency. UMC has created Tranquility Rooms for<br />
staff as safe spaces where they can relax, calm, and<br />
de-stress for a time. It is hoped that staff will regain<br />
necessary emotional, mental, and physical resiliency,<br />
thereby restoring work effectiveness.<br />
Purpose:<br />
To explore the feasibility of maintaining the<br />
Tranquility Rooms permanently, and possibly creating<br />
more rooms, UMC’s Tranquility Rooms were evaluated<br />
for their effectiveness in reducing stress experienced by<br />
staff.<br />
Methods:<br />
Each Tranquility Room is decorated as a home-like<br />
room, offering the C.A.R.E. Channel, an essential oil<br />
diffuser, ambient lighting, a comfortable recliner, and<br />
several modalities known for their calming effects. The<br />
sample included 132 staff, from <strong>December</strong> 2019 to<br />
September <strong>2020</strong>, who voluntarily completed 10-point<br />
Likert scales to measure perceived stress before versus<br />
after using the Tranquility Rooms.<br />
Results and Conclusion:<br />
The Tranquility Rooms demonstrated significant<br />
reduction in employee stress while on-the-job. The<br />
rooms were used throughout all work shifts. Staff<br />
stated the rooms reduced stress and helped them<br />
perform more effectively. Pre-tranquility room use<br />
stress scores were 6.83 compared to 2.43 after<br />
use of the tranquility room (p = < 0.05). Staff have<br />
commented they do not want it known how often<br />
they are using the rooms. Staff are asking for more<br />
Tranquility Rooms and because of the positive<br />
response, UMC is looking for ways to create more<br />
Tranquility Rooms throughout the hospital. Additional<br />
Tranquility Rooms would reduce travel time required<br />
for busy staff. Some staff have even taken it upon<br />
themselves to create Tranquility Rooms within their<br />
own departments.<br />
Implication for Practice:<br />
According to JAMA, hospitals with better nursing<br />
work environments for nurses provided better quality<br />
patient care.
<strong>December</strong> <strong>2020</strong>, January, February 2021 <strong>Nevada</strong> <strong>RNformation</strong> • Page 7<br />
Taking Time for Self-Care during COVID<br />
By Michelle McGrorey BSN, RN, HTCP, HBN-BC, OCN, HMIP, NCCA and<br />
Vicki Walker DNP, BS, RN<br />
During this time of pandemic practicing nurses are faced with extreme stress<br />
both at home and work. Now more than ever is the time to pause and appraise<br />
your routine for self-care. Practices like mindfulness, aromatherapy, meditation, etc.<br />
may be familiar to you or you may be a novice just exploring what is out there. To<br />
advance your learning here are a few tips for aromatherapy practices.<br />
Today there is an abundance of products for aroma therapy, but consumer<br />
beware, many products on the market are not pure essential oils and you may not<br />
experience the expected biological effects without ensuring product quality. The<br />
essential oil effects that we are suggesting in this article are based on pure plant oil<br />
extracts. We do recommend if you are unfamiliar with product selection that you<br />
seek further guidance from experts.<br />
Here are some simple guidelines:<br />
Lavender -<br />
(Lavandula<br />
angustifolia)<br />
Cedarwood -<br />
(Juniperus<br />
virginiana)<br />
Vetiver -<br />
(Vetiveria<br />
zizaniodes)<br />
Oils to Support Relaxation<br />
Oil Primary Effects Uses Techniques for<br />
Use*<br />
Bergamot -<br />
(Citrus bergamia)<br />
Roman<br />
chamomile -<br />
(Chamaemelum<br />
Nobile)<br />
Cinnamon -<br />
(Cinnamomum<br />
zeylanicum)<br />
Clove -<br />
(Eugenia<br />
caryophyllata)<br />
Eucalyptus -<br />
(Eucalyptus<br />
globulus)<br />
Relaxation, airborne<br />
antimicrobial, antiinflammatory<br />
Antibacterial, CNS<br />
sedating, antiinflammatory<br />
CNS sedating,<br />
immunostimulant,<br />
Anti-inflammatory<br />
Anti-inflammatory,<br />
antispasmodic,<br />
antibacterial<br />
Analgesic, antispasmodic,<br />
antiinflammatory<br />
Sleep support<br />
Calming<br />
Stress reduction<br />
Calming<br />
Respiratory<br />
support<br />
Stress reduction<br />
Sleep support<br />
Relaxation Mood<br />
support<br />
Support emotional<br />
health<br />
Respiratory<br />
support<br />
Stress reduction<br />
Sleep support<br />
Pain support<br />
Muscle relaxation<br />
Oils to Support Immunity<br />
Inhalation<br />
Topical<br />
Inhalation<br />
Topical<br />
Inhalation<br />
Topical<br />
Inhalation<br />
Topical<br />
Safety – can be<br />
phototoxic<br />
Inhalation<br />
Topical<br />
Oil Primary Effects Uses Techniques for<br />
Use*<br />
Frankincense -<br />
(Boswellia carterii)<br />
Lemon -<br />
(Citrus limon)<br />
Anti-inflammatory,<br />
antibacterial,<br />
antioxidant,<br />
immunomodulatory<br />
Analgesic, antiinflammatory,<br />
anti-bacterial, antiviral,<br />
anti-fungal,<br />
immunostimulant<br />
Anti-inflammatory,<br />
analgesic, antibacterial,<br />
airborne<br />
anti-microbial<br />
Anti-inflammatory,<br />
antibacterial,<br />
antifungal<br />
Anti-inflammatory,<br />
antibacterial,<br />
antioxidant<br />
Immune support,<br />
Great for diffusing<br />
as an air purifier<br />
Stress reduction<br />
Great to use for<br />
natural cleaning<br />
Immune support<br />
Pain support<br />
Mood support<br />
Respiratory<br />
support<br />
Immune support<br />
Use for natural<br />
cleaning<br />
Emotional support<br />
Immune support<br />
Mood support<br />
Immune support<br />
Use in natural<br />
cleaning<br />
Inhalation, room<br />
spray, cleaning<br />
Safety – heavily<br />
dilute before use;<br />
not for children<br />
< 10<br />
Inhalation<br />
Topical: only if<br />
heavily diluted<br />
Safety: avoid<br />
with severe<br />
renal disease;<br />
avoid in young<br />
children; may have<br />
anticoagulant<br />
properties; heavily<br />
dilute before use<br />
Inhalation<br />
Topical<br />
Safety – avoid<br />
in babies and<br />
children
Page 8 • <strong>Nevada</strong> <strong>RNformation</strong> <strong>December</strong> <strong>2020</strong>, January, February 2021<br />
NNA Environmental Health Committee<br />
Environmental Health and Homelessness<br />
Shelter is a basic necessity that many of us take for<br />
granted. Since prehistoric times, humans have been<br />
building structures to protect themselves from the<br />
elements. The good fortune to wake up in a warm<br />
bed, turn on the faucet for water, open our refrigerator<br />
for food, and have access to a shower are all modern<br />
conveniences that are commonplace for the majority<br />
of the population. Without a home, it is difficult for<br />
individuals and families to achieve stability, personal<br />
hygiene, obtain employment, receive an education, or<br />
receive necessary health services. People experiencing<br />
homelessness are at an increased risk of premature<br />
death, have higher rates of chronic health conditions,<br />
including mental illness and substance abuse, and use<br />
emergency services more frequently (Maness & Khan,<br />
2014). In the last decade, homeless encampments<br />
have been on the rise, due to the lack of affordable<br />
housing and absence of a living wage (National Law<br />
Center on Homelessness and Poverty, 2017). At the<br />
bedside and in the community, nurses observe in their<br />
patients the importance of shelter and the associated<br />
health impacts of living on the streets on a daily basis.<br />
This article offers a perspective on the challenges of<br />
people experiencing homelessness and the associated<br />
environmental health-related issues.<br />
Environmental Health and Vulnerable populations<br />
It is common knowledge that collective human<br />
actions have negative impacts on our environment<br />
and human health. An estimated 12.6 million people<br />
die every year as a result of avoidable environmental<br />
health risks such as climate change and environmental<br />
degradation (World Health Organization, <strong>2020</strong>).<br />
Vulnerable populations such as those experiencing<br />
homelessness are disproportionately affected<br />
by environmental degradation and often lack<br />
representation in environmental regulation and policy.<br />
This same population has a higher risk of disease<br />
processes associated with environmental hazards<br />
(Ramin & Svoboda, 2009).<br />
The COVID-19 Pandemic<br />
History has shown that large-scale outbreaks of<br />
infectious disease present challenges to everyone,<br />
especially the most vulnerable members of the<br />
population. The COVID-19 pandemic has exacerbated<br />
health disparities experienced by the homeless<br />
population and limited their access to available<br />
resources. People experiencing homelessness have<br />
a higher risk of contracting COVID-19 and are<br />
differentially burdened by the impacts of the pandemic<br />
(Karaye & Horney, <strong>2020</strong>). Persons experiencing<br />
homelessness who had health risks prior to the<br />
pandemic, now have new barriers to accessing income,<br />
resources, and healthcare.<br />
The pandemic has had a special impact on the<br />
homeless population here in <strong>Nevada</strong>. Representatives<br />
from various shelters across the state of <strong>Nevada</strong> have<br />
reported that many shelters had to either reduce<br />
capacity, place a temporary hold on accepting new<br />
clients, or shut down temporary shelters completely as<br />
a result of the pandemic.<br />
Environmental Injuries Related to Homelessness<br />
People who are homeless endure various<br />
environmental injuries as a result of extreme weather<br />
conditions, climate change impacts, and simply living<br />
outside without shelter (Ramin & Svoboda, 2009).<br />
Health becomes a low priority for homeless individuals<br />
who are struggling to meet their basic needs (Koh &<br />
O’Connell, 2016). In interviews with Terry Lindeman,<br />
Director of Family Promise in Las Vegas and Emma<br />
Neville, program manager at Tahoe Coalition for the<br />
Homeless (TCH), it is evident that environmental health<br />
conditions are dependent on the climate of a particular<br />
region, as there is high variability in temperature and<br />
terrain across the state of <strong>Nevada</strong>.<br />
The homeless population in the Tahoe area suffer<br />
from cold-related illnesses such as hypothermia,<br />
frostbite, and acute exacerbations of chronic respiratory<br />
diseases related to wildfires and high altitude. Whereas,<br />
the homeless population in Las Vegas suffer from heatrelated<br />
injuries such as sunburns, pavement burns,<br />
heat exhaustion, and heat stroke. Both regions see<br />
incidences of dehydration, bug bites, and improper<br />
wound healing due to poor hygiene and unsanitary<br />
living conditions. When caring for a patient who is<br />
experiencing homelessness, it is important for nurses<br />
to include assessments for these conditions and expand<br />
their focus beyond the major presenting complaint.<br />
Hearing a first-hand experience of being homeless<br />
can be a powerful reminder of the many challenges<br />
faced by this population. One of the Tahoe Coalition<br />
for the Homeless clients I spoke with told me her<br />
story, “one time I woke up in the hospital wrapped in<br />
warming blankets and the doctors told me my body<br />
temperature had reached 80 degrees; that was the<br />
night my sister wouldn’t let me into her house and I fell<br />
asleep outside without a sleeping bag” (Anonymous<br />
homeless client, personal communication, October 21,<br />
<strong>2020</strong>).<br />
The Homeless Population in <strong>Nevada</strong><br />
According to recent statistics, there are currently<br />
7,169 homeless residents in <strong>Nevada</strong> which includes<br />
families, young adults, and veterans. Of those<br />
people, 727 on average are unsheltered at night (U.S.<br />
Interagency Council on Homelessness, 2019). As of<br />
2019, there are roughly 567,715 people in the United<br />
States who are experiencing homelessness (National<br />
Alliance to End Homelessness, <strong>2020</strong>). It is difficult to<br />
find current statistics on homelessness following the<br />
COVID-19 pandemic.<br />
As it stands, there are not enough resources<br />
in <strong>Nevada</strong> to fulfill the needs of everyone who<br />
experiences homelessness. <strong>Nevada</strong> requires more viable<br />
solutions to this growing problem, as there are still<br />
hundreds of <strong>Nevada</strong>ns without shelter on any given<br />
night. The recommendations from the CDC for people<br />
experiencing homelessness is to continue placing<br />
them in temporary stable housing as a priority and<br />
allow those who are living in encampments to remain<br />
where they are (CDC, <strong>2020</strong>). Yet, people experiencing<br />
homelessness continue to be displaced from these<br />
encampments without guaranteed housing placement.<br />
Homeless Encampments and Environmental Impacts<br />
All human beings have an impact on the<br />
environment with daily living. Homeless encampments<br />
along the Truckee River in both Reno and Tahoe<br />
have detrimental impacts to this natural habitat and<br />
essential water source. Trash, human waste, and<br />
hypodermic needles litter the river banks and put these<br />
communities at risk. Recently, during the pandemic,<br />
the city of Reno has ramped up efforts to clean up this<br />
area due to environmental threats and fire hazards,<br />
and are displacing homeless people in the process<br />
(Conrad, <strong>2020</strong>). However, these types of initiatives<br />
are not getting to the root of the problem, which is<br />
providing a permanent housing solution for people<br />
who are homeless to protect their health, the health<br />
of the public, and the natural environment. Many<br />
people experiencing homelessness simply don’t know<br />
what to do with their waste; anonymous clients of the<br />
Tahoe Coalition for the homeless reported that there<br />
are no public areas to take trash without incurring<br />
illegal dumping fees, bears are frequently encroaching<br />
on their encampments, and there is a lack of public<br />
bathrooms.<br />
Solutions<br />
Housing is the obvious solution to ending<br />
homelessness and the associated negative health<br />
outcomes and environmental impacts. There are<br />
encouraging examples of projects that have been<br />
successful in reducing homelessness. In the United<br />
States, there are 80 communities and three states<br />
that have ended veteran homelessness and four<br />
communities that have ended chronic and veteran<br />
homelessness; this means they have established<br />
systems to ensure that homelessness is rare, brief,<br />
and a one-time occurrence (United States Interagency<br />
Council on Homelessness, 2019). One of the silver<br />
linings of this pandemic is the public health response<br />
from the federal government. The Coronavirus Aid,<br />
Relief, and Economic Security (CARES) Act was passed<br />
by Congress March 27th, <strong>2020</strong> and has distributed<br />
over $2 trillion in economic relief packages to local<br />
communities across the country to protect people from<br />
the public health and economic impacts of COVID-19<br />
(U.S. Department of Treasury, n.d.).<br />
Emma Neville of the Tahoe Coalition for the<br />
Homeless (TCH) received funding from project<br />
Roomkey, a California state program that enables<br />
Encampments of the Homeless<br />
Photos courtesy of the Tahoe Coalition for the Homeless, taken by Ryan Hunt
<strong>December</strong> <strong>2020</strong>, January, February 2021 <strong>Nevada</strong> <strong>RNformation</strong> • Page 9<br />
NNA Environmental Health Committee<br />
people experiencing homelessness to shelter in place<br />
through temporary housing. One of the goals with<br />
these new projects is to reduce emergency visits<br />
related to environmental injuries through housing<br />
and preventative care services. “One of the best<br />
things I hear with this job is, thank you for saving my<br />
life” (Personal communication with Emma Neville,<br />
November 10, <strong>2020</strong>).<br />
Terry Lindemann of Family Promise of Las Vegas<br />
reports that housing first is the most important answer<br />
to ending homelessness, and reports that collaboration<br />
between nonprofit organizations in Southern <strong>Nevada</strong><br />
has been key to helping people in the community who<br />
are homeless, as she says, “it is not going to be one of<br />
us, it is going to be all of us” (Personal Communication,<br />
Terry Lindeman, November 12, <strong>2020</strong>).<br />
A Success Story<br />
Terry Lindeman recalls a successful story of one of<br />
the families who was helped through Family Promise<br />
of Las Vegas: “A story I remember well, was a single<br />
mother who was discharged from the hospital with<br />
chronic kidney disease and during her hospitalization<br />
she had lost her job and her apartment. We were<br />
able to place her and her family in housing and pay<br />
her vehicle insurance in order for her to get to her<br />
daily dialysis appointments. From there, we continued<br />
to work with this family in order to achieve their<br />
goals of returning to work, getting back into their<br />
own apartment, and helped them to remain selfsufficient.<br />
This family would have faced insurmountable<br />
challenges without the assistance of our nonprofit<br />
and today they are housed and doing well and they<br />
have been able to overcome all of their challenges”.<br />
(Personal communication with Terry Lindeman,<br />
November 12, <strong>2020</strong>).<br />
The Nurse’s Role: Care & Compassion<br />
Nurses have a responsibility at the bedside and<br />
within their communities to help people experiencing<br />
homelessness to improve their health through<br />
education, outreach, and referral to appropriate<br />
resources. These nurse-led interventions increase<br />
participation in public health programs, prevent risky<br />
health behaviors, and improve health outcomes<br />
(Weber, 2019). Nurses also have an obligation to<br />
advocate for policies that aim to reduce homelessness,<br />
climate change, and environmental degradation. The<br />
nurse’s ability to uphold equity and respect when<br />
caring for people experiencing homelessness is crucial<br />
to establishing a trusting relationship with the patient<br />
and helping guide them toward available resources.<br />
In a recent survey conducted by TCH, clients were<br />
asked “what is the hardest thing you face as a result<br />
of being homeless,” and the overwhelming response<br />
was “I don’t feel like I’m treated like a human being<br />
anymore,” one individual stated, “people don’t want<br />
to look me in the eye.” Homelessness is a traumatic<br />
experience and it is imperative that nurses move<br />
beyond judgment and lead with compassion. At the<br />
core of our profession is caring!<br />
Authors<br />
References<br />
Centers for Disease Control and Prevention (<strong>2020</strong>,<br />
September 16). Retrieved October 22, <strong>2020</strong>, from<br />
https://www.cdc.gov/coronavirus/2019-ncov/<br />
community/homeless-shelters/faqs.html<br />
Conrad, B. (<strong>2020</strong>, September 24). City to ramp up homeless<br />
camp cleanups, enforce no camping ordinances. This is<br />
Reno. Retrieved from https://thisisreno.com/<strong>2020</strong>/09/<br />
city-to-ramp-up-homeless-camp-cleanups-enforce-nocamping-ordinances/<br />
Karaye, I. M., & Horney, J. A. (<strong>2020</strong>). The impact of social<br />
vulnerability on COVID-19 in the U.S.: An analysis of<br />
spatially varying relationships. American Journal of<br />
Preventive Medicine, 59(3), 317–325. doi: 10.1016/j.<br />
amepre.<strong>2020</strong>.06.006<br />
Koh, H. K., O, C. J. J., & O’Connell, J. J. (2016). Improving<br />
Health Care for Homeless People. JAMA: Journal of<br />
the American Medical Association, 316(24), 2586–<br />
2587. https://doi-org.unr.idm.oclc.org/10.1001/<br />
jama.2016.18760<br />
Maness D. L., Khan, M. (2014) Care of the homeless: an<br />
overview. American Family Physician, 89(8), 634-40.<br />
National Alliance to End Homelessness. (<strong>2020</strong>). State of<br />
Homelessness: <strong>2020</strong> Edition. Retrieved from https://<br />
endhomelessness.org/homelessness-in-america/<br />
homelessness-statistics/state-of-homelessness-<strong>2020</strong>/<br />
Shelters and Resources for People Experiencing Homelessness in <strong>Nevada</strong><br />
Adult Services<br />
Volunteers of America, Northern <strong>Nevada</strong> -<br />
Reno<br />
website: www.voa-ncnn.org/northern-nevada<br />
phone: (775) 329-4141<br />
address: 335 Record St., Reno, NV 89512<br />
Reno-Sparks Gospel Mission<br />
website: www.rsgm.org<br />
phone: (775) 323-0386<br />
Friends in Service Helping - Carson City<br />
website: www.nvfish.com<br />
phone: (775) 882 – 3474<br />
address: 138 E Long St, Carson City, NV 89706<br />
Tahoe Coalition for the Homeless - Tahoe<br />
website: www.tahoehomeless.org<br />
phone: (530) 600-2822<br />
address: PO Box 13514, South Lake Tahoe, CA,<br />
96151<br />
Friends in Service Helping - Elko<br />
website: www.fishelko.org<br />
address: 487 South 5th Street, Elko, NV 89801<br />
phone: (775) 738-7800<br />
Las Vegas Rescue Mission<br />
website: www.vegasrescue.org<br />
phone: (702) 382-1766<br />
address: 480 West Bonanza Rd, Las Vegas, NV<br />
89106-3227<br />
Family Promise of Las Vegas<br />
website: www.familypromiselv.com<br />
phone: (702) 638-8806<br />
address: 1410 S. Maryland Pkwy., Las Vegas, NV<br />
89104<br />
National Law Center on Homelessness and Poverty. (2017).<br />
Tent city, USA: the growth of America’s homeless<br />
encampments and how communities are responding<br />
[pdf]. Retrieved from https://nlchp.org/wp-content/<br />
uploads/2018/10/Tent_City_USA_2017.pdf<br />
Ramin, B., & Svoboda, T. (2009). Health of the homeless<br />
and climate change. Journal of Urban Health: Bulletin<br />
of the New York Academy of Medicine, 86(4), 654–<br />
664. https://doi.org/10.1007/s11524-009-9354-7<br />
United States Department of Treasury (n.d.) The CARES act<br />
works for all Americans. Retrieved November, 14 from<br />
https://home.treasury.gov/policy-issues/cares<br />
United States Interagency Council on Homelessness (2019).<br />
<strong>Nevada</strong> Homeless Statistics. Retrieved on October 20,<br />
<strong>2020</strong>, from https://www.usich.gov/homelessnessstatistics/nv/<br />
United States Interagency Council on Homelessness (2019).<br />
Communities that have ended homelessness. Retrieved<br />
October 20, <strong>2020</strong> from https://www.usich.gov/<br />
communities-that-have-ended-homelessness/<br />
Weber, J. J. (2019). A systematic review of nurse led<br />
interventions with populations experiencing<br />
homelessness. Public Health Nursing, 36(1), 96–106.<br />
https://doi-org.unr.idm.oclc.org/10.1111/phn.12552<br />
World Health Organization. Climate change and human<br />
health. Retrieved November 11, from https://www.<br />
who.int/globalchange/mediacentre/news/cop23-23-<br />
key-messages/en/<br />
Youth Services<br />
Eddy House - Reno<br />
website: www.eddyhouse.org<br />
phone: (775) 384-1129<br />
address: 888 Willow St., Reno, NV 89502<br />
Shannon West Homeless Youth Center<br />
website: www.helpsonv.org<br />
phone: (702) 369-4357<br />
address: 1650 E. Flamingo Rd. Las Vegas, NV 89119<br />
<strong>Nevada</strong> Partnership for Homeless Youth<br />
website: www.nphy.org<br />
phone: (702) 383-1332<br />
address: 4981 Shirley St, Las Vegas, NV 89119<br />
Additional Resources<br />
HopeLink of Southern <strong>Nevada</strong><br />
website: www.link2hope.org<br />
phone: (702) 566-0576<br />
address: 178 Westminster Way, Henderson, NV<br />
89015<br />
<strong>Nevada</strong> 211 of the <strong>Nevada</strong> Department of<br />
Health and Human Services<br />
website: www.nevada211.org/shelter<br />
phone: 211<br />
City of Reno: Homeless Resource Page<br />
www.reno.gov/government/departments/<br />
community-development/housing-homelessresources/homeless-resources<br />
<strong>Nevada</strong> Homeless Alliance<br />
website: www.nevadahomelessalliance.org<br />
Help Hope Home<br />
https: www.helphopehome.org<br />
Tihisha Vaccaiah, RN<br />
The Orvis School of<br />
Nursing<br />
University of <strong>Nevada</strong><br />
Reno<br />
Bernadette M. Longo,<br />
Ph.D., RN, APHN-BC,<br />
CNL, FAAN<br />
Chair, NNA’s<br />
Environmental Health<br />
Committee<br />
Associate Professor<br />
Emerita, Orvis School<br />
of Nursing<br />
January 2021<br />
NATIONAL RADON<br />
ACTION MONTH<br />
Get a free radon test kit!<br />
Jan. 1 thru Feb. 28<br />
call the <strong>Nevada</strong> Radon Hotline<br />
888-RADON10 (888-723-6610)<br />
All <strong>Nevada</strong> homes should be tested for radon!
Page 10 • <strong>Nevada</strong> <strong>RNformation</strong> <strong>December</strong> <strong>2020</strong>, January, February 2021<br />
Antimicrobial Stewardship – Infection Prevention<br />
SARS-CoV-2 and Infection Prevention - Stop the Bleed<br />
By Norman Wright, RN, BSN, MS – Infection Preventionist<br />
It is Thanksgiving Day <strong>2020</strong>. SARS-CoV-2 (Coronavirus)<br />
infections and Covid-19 hospitalizations are surging for the<br />
third time this year, and the wave is building with no crest<br />
in sight. During the first wave back in April <strong>2020</strong>, <strong>Nevada</strong>’s<br />
highest seven-day running average of SARS-CoV-2 infections<br />
was only 161. The second wave peaked on July 20, <strong>2020</strong>,<br />
when the 7-day average of daily infections increased to<br />
1,171.<br />
We are now experiencing the third wave, and it is hitting<br />
hard. We have blown past last summer’s numbers, and on<br />
November 26, <strong>2020</strong>, <strong>Nevada</strong>’s 7-day average of infections<br />
more than doubled to 2,415.<br />
Before the election, people attended packed campaign rallies, many without<br />
masks, and street demonstrations continue. CDC’s recommendations are ignored,<br />
and people crowd into airports traveling to spend Thanksgiving with family.<br />
Continuing to disregard basic infection prevention guidelines will result in infections,<br />
hospitalizations, and deaths, to increase astronomically.<br />
Graph #1 <strong>Nevada</strong>’s Daily Infections<br />
https://www.worldometers.info/coronavirus/usa/nevada/<br />
Graph #2 <strong>Nevada</strong>’s Hospitalizations<br />
https://covidtracking.com/data/state/nevada/hospitalization<br />
It is Thanksgiving, and to date, 2,092 <strong>Nevada</strong>ns have died. Yes, treatment options<br />
are improved, and the percentage of deaths vs. the number of infections has<br />
decreased; the only problem, infection rates are skyrocketing.<br />
I pray I am wrong, but I fear deaths will increase at a blistering pace in the<br />
coming months. The Institute of Health Metrics (IHME) latest estimate is that by<br />
February 2021, <strong>Nevada</strong>’s death toll will be over 3,700. The unfortunate reality,<br />
deaths peak about a month after the number of infections begins to decrease, and<br />
<strong>Nevada</strong>'s daily infection numbers continue to escalate.<br />
At NNA’s 2019 annual convention, a “STOP The BLEED” educational session<br />
was taught. Without going into details, the most important takeaway was, “When<br />
someone is bleeding, do something, anything, to stop the bleeding." Tear off<br />
your sweaty shirt or your belt, use anything at all that can compress, or acts as a<br />
tourniquet, to stop a person from bleeding out.<br />
That said, an infection prevention article telling you to press an unsanitary towel<br />
or to tie your shoelace above an open wound seems to be a non sequitur, but it<br />
is not. First Aid Basics are ABC (Airway, Breathing, Circulation). Bottom line, if<br />
the person dies from bleed out before getting to the hospital, infection prevention<br />
recommendations and antimicrobials are of no concern nor useful.<br />
https://www.cdc.gov/coronavirus/2019-ncov/covid-data/forecasting-us.html<br />
When someone is bleeding out, immediate action must be taken, or death<br />
quickly occurs. Yesterday's 7-day average of SARS-CoV-2 deaths in the United States<br />
was 1,708, and the CDC estimates that the numbers will increase.<br />
September 11, 2001, when 2996 Americans died after four hijacked airplanes<br />
crashed into the World Trade Center, the Pentagon, and a field in Pennsylvania - is a<br />
date burned into my memory – and now, every two days, more Americans die from<br />
COVID-19 than died on 9/11 - think about that for a minute.<br />
The daily tally of COVID-19 deaths has continued for so long that many have<br />
become numb to the reality and are experiencing “COVID Fatigue." Some of us, too<br />
many, refuse to wear masks, shelter in place, or take other necessary precautions.<br />
Despite the increase in hospitalizations and deaths, mixed messaging has caused<br />
confusion. Some still don’t believe SARS-CoV-2 is real, while others are letting their<br />
guard down.<br />
Media emphasis has been on a "cure," not prevention. Ineffective remedies such<br />
as hydrochlorothiazide were hyped, and mitigation efforts were minimized, even<br />
discounted. The result, infections are spreading like wildfire.<br />
Vaccine development has been politicized and hyped for months. Vaccines<br />
are now in the process of being approved, and indications are, before the New<br />
Year, there will be at least two different vaccines available, some claiming a 95%<br />
immune response. Hopefully, by February 2021, we will be vaccinating health<br />
care professionals, first responders, vulnerable senior citizens, and others with comorbidities.<br />
But it will take many more months before a large percentage of our<br />
population can be vaccinated.<br />
The term “Herd Immunity” is being discussed in the media as a way out of<br />
our dilemma, but between 70 to 90 percent of our population must be infected<br />
or vaccinated before “Herd Immunity” is achieved, and this probably will not occur<br />
until early summer, if at all.<br />
A problem with “Herd Immunity Theory” is that immunity to Coronavirus may<br />
not last long. Unlike smallpox and polio vaccines, SARS-CoV-2 immunity may last<br />
only a year or less. (1) (2) (3) (4)<br />
The trajectory of how quickly Coronavirus infections spread is frightening,<br />
and this is where the analogy of comparing the "slow-motion pandemic" we are<br />
experiencing is equated with the quick action that must be taken to preserve a life<br />
when witnessing someone bleeding after a car accident, or a mass shooting. — (See<br />
accompanying article Stop the Bleed Training).<br />
SARS-CoV-2 is a novel virus that spreads rapidly. Every day we learn more<br />
about it, and older data that is less accurate gets mixed in. Since last January, we<br />
have been fed a constant barrage of information and misinformation regarding<br />
COVID-19. It is on TV, in newspapers, the Internet, Twitter, and various other media<br />
sources.<br />
Masks help to stop spreading infection from the wearer to others, and masks also<br />
protect the wearer from being infected, but wearing a mask has become politicized.<br />
Many media sources continue to spread doubt, causing confusion and noncompliance.<br />
The result, the number of infections is soaring into the stratosphere. (5)<br />
Basic infection prevention practices, wearing a mask, social distancing, hand<br />
hygiene, and doing other preventative measures is how we stop the slow bleed of<br />
hospitalizations and deaths from COVID-19, and this is where the analogy of saving<br />
the life of someone who is bleeding out differs from the unified approach that must<br />
be taken to stop the spread of the infection.<br />
Mitigation requires buy-in from society as a whole, and if we fail, tens of<br />
thousands more will unnecessarily die.<br />
But viewing the pandemic only in terms of the number of hospitalizations<br />
or deaths is shortsighted. Ignoring the societal, economic, and psychological<br />
impacts, many recovering from a SARS-CoV-2 infection, even those who were not<br />
hospitalized, have a different form of "COVID fatigue," which is one of the many<br />
post-infection symptoms that “Long Haulers” have. (6)<br />
Today is Thanksgiving, and <strong>2020</strong> is a year we will all remember. Let’s be thankful<br />
for all we have because looking at what is lost only creates negativity that generates<br />
a downward spiral.<br />
After the October 1 Las Vegas shooting occurred, the term “Vegas Strong”<br />
resounded, and we recovered. It is time for us to work together, and when we do,<br />
<strong>Nevada</strong> Strong, indeed USA Strong, will echo around the world.<br />
Ultimately the actions we take today determine our future. Not just your future,<br />
but a future that our children and their grandchildren hopefully will enjoy. Ultimately<br />
infection prevention is an individual responsibility that everyone must practice. If we<br />
don't deal with COVID-19 locally, it is impossible to control it anywhere.<br />
Onward to 2021 – and the future!<br />
Citations:<br />
(1) https://www.niaid.nih.gov/research/immune-response-covid-19<br />
(2) https://www.cdc.gov/coronavirus/2019-ncov/hcp/faq.html#COVID-19-Risk<br />
(3) https://www.mayoclinic.org/diseases-conditions/coronavirus/in-depth/herd-immunityand-coronavirus/art-20486808<br />
(4) https://apic.org/monthly_alerts/herd-immunity/<br />
(5) https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/cloth-face-coverguidance.html<br />
(6) https://www.mayoclinic.org/coronavirus-long-term-effects/art-20490351
<strong>December</strong> <strong>2020</strong>, January, February 2021 <strong>Nevada</strong> <strong>RNformation</strong> • Page 11<br />
Healthy Nurses<br />
By Tracey Long PhD, APRN-BC, CDE, CNE, CCRN<br />
Nurses educate patients<br />
about the value to get vaccines<br />
all the time, but how many<br />
nurses actually get those same<br />
vaccines for themselves? The<br />
annual influenza vaccination<br />
is often a requirement for<br />
healthcare professionals to<br />
reduce absenteeism and<br />
reduce influenza-related<br />
morbidity and mortality,<br />
however only approximately<br />
78% of health care personnel actually comply with<br />
the recommendations for themselves (CDC, 2018).<br />
Coverage was lowest among nurses working in longterm<br />
care settings. According to a qualitative study,<br />
the reasons why nurses decline influenza vaccination<br />
included mistrust of safety, overuse of vaccinations<br />
and even rebellion over being told what to put in their<br />
own body and wanted decisional autonomy (Pless et al.<br />
2017). And yes, nurses do have a right, just like anyone,<br />
to choose.<br />
However, nurses hold a responsibility to deliver<br />
complete and objective information when providing<br />
patient education. Research proves a nurse’s opinion<br />
sways the advice they give patients and vaccinated<br />
nurses are more inclined to recommend vaccination<br />
than those who are unvaccinated (Smith et al, 2016).<br />
Interestingly, the more highly educated the nurse is, the<br />
higher the incidence they will be vaccinated.<br />
Just as each nurse has unique values and beliefs,<br />
each healthcare professional is an individual who<br />
may decide their position about personal vaccination.<br />
It is also true that nurses may deliver a healthcare<br />
intervention they do not believe in, yet still administer<br />
the care or medication the Provider orders. Regardless<br />
of which side you take, every nurse has the right<br />
to choose for themselves their habits of health and<br />
balance that with their nursing duties.<br />
We also have seen polar opposite opinions from<br />
nurses during the COVID-19 worldwide pandemic<br />
and face mask use in the past nine months. With the<br />
production of hoped-for vaccines against COVID-19,<br />
nurses will be asked by friends, family and colleagues<br />
what to do. Regardless of a nurse’s personal or<br />
political opinion, current health counsel against<br />
COVID-19 should still be given by nurses and includes<br />
the following based on the CDC guidelines: wash<br />
hands frequently with soap and water or any alcoholbased<br />
sanitizer, dispose of used tissues and masks<br />
into a plastic-lined waste bin instantly, use a tissue<br />
to cover your mouth and nose while coughing or<br />
sneezing, don’t touch your mouth, eyes, or nose,<br />
avoid close contact with any individual having cold or<br />
flu-like symptoms, clean surfaces often, avoid sharing<br />
utensils, food, or drinks, avoid crowded places and<br />
stand six feet apart from others. If you are unwell, seek<br />
medical attention immediately, stay at home and avoid<br />
contacting others.<br />
There is no doubt that despite adherence to the<br />
CDC guidelines, people are still getting sick and nurses<br />
are exhausted. The media reports higher anxiety,<br />
suicide and depression in America in <strong>2020</strong> because<br />
of the long-term consequences of COVID-19 and<br />
social distancing. As people rely on the opinion and<br />
education of nurses, we can make a difference in the<br />
possibly worse virus the world is experiencing- fear and<br />
depression.<br />
Beyond the prudent CDC guidelines against<br />
COVID-19, the next level of patient education for<br />
health care guidelines for mental health may include<br />
the following for yourself and those you educate:<br />
Media Distancing<br />
If media is creating or worsening your anxiety, stop<br />
consuming it. Distance yourself from the negativity<br />
of media and fear (ADAA, <strong>2020</strong>). You can still stay<br />
informed by catching major headlines on an occasional<br />
review of weekly highlights, but you don’t have to<br />
bombard yourself with the plethora of negativity and<br />
focus on racism, hatred, crime and distress most news<br />
cycles focus on.<br />
Take Control of Your Thoughts<br />
The more your mind focuses on worst-case<br />
scenarios, the more anxious you will feel. Rather than<br />
allowing the very normal negative and fearful thoughts<br />
that pass through your brain to stay and destroy your<br />
energy, take action into problem solving. Much of<br />
anxiety and stress comes from fear of the unknown<br />
and lack of control. Rather than allowing your mind to<br />
entertain doomsday thoughts, be proactive and focus<br />
your thoughts on actions you can take that are in your<br />
control. Proactive action towards your own goals is a<br />
great way to crush pessimism.<br />
Focus on Being Productive and New Ways of<br />
Enjoying Life<br />
Although you cannot control a worldwide<br />
pandemic or political crisis, you do have control<br />
over your response to the crisis. Among the many<br />
humorous posts on social media was the comparison<br />
of two women who each announced, “I’m using<br />
this quarantine time to better myself by developing<br />
a new skill at home,” while the other quipped “I just<br />
ate carrot cake with my bare hands.” Life isn’t what<br />
happens to you, but rather how you choose to respond<br />
to it. A good sense of humor helps a lot. Pass the carrot<br />
cake. Fork is optional.<br />
Engage in Stress Reducing Activities<br />
Train your mind to manage stress by employing a<br />
variety of strategies including focusing on gratitude,<br />
exercising your body, guided meditation, yoga, writing<br />
gratitude notes and more, which can lower stress.<br />
Find something new you’ve been wanting to do<br />
but could never find the time to learn or do. Life will<br />
never be stress-free, but your actions can help make it<br />
manageable and not destructive.<br />
Do Not Go Beyond CDC Guidelines<br />
Nurses can help decrease the anxiety and stress of<br />
our patients by confirming that people do not need to<br />
be compulsive about handwashing, taking off clothes<br />
before entering a house, and washing off groceries<br />
before allowing them into the home. These are anxiety<br />
measures, not the CDC measures.<br />
Preserve a Sense of Normalcy<br />
When social distancing is still recommended, you<br />
can still maintain a routine by making your bed in the<br />
morning, getting dressed for work even if you work<br />
from home, exercise at home instead of a gym, and<br />
have a scheduled dinner as usual but maybe invite<br />
friends over a video chat platform. Social distancing<br />
doesn’t mean social isolation.<br />
Seek Out Professional Help<br />
For many people, distressful times can reveal<br />
underlying medical or mental health conditions that<br />
do require professional help. Nurses can help people<br />
recognize if what the patient is experiencing is normal<br />
or if they need additional resources and help. This<br />
includes being in-tune with the mental health of your<br />
own colleagues and nurses you work with. After the<br />
Twin Towers in New York City fell September 11, 2001,<br />
nurses were there at the side of the firefighters and<br />
rescue crews to assess and strengthen them in their<br />
work. Nursing is a team sport and we need to watch<br />
out for each other.<br />
In the year of the Nurse, nurses really did shine and<br />
continue to earn the title of most trusted profession.<br />
People rely on nurses for good health education and<br />
by being well-informed, presenting information and<br />
resources objectively, we can collectively be a strength<br />
to the well-being of our communities.<br />
For ideas to help yourself, your family and your<br />
patients, feel free to share the Coping Calendar<br />
designed by www.actionforhappiness.org.<br />
References<br />
Anxiety and Depression Association of America, (ADAA)<br />
(<strong>2020</strong>). COVID-19 anxiety reduction strategy. Retrieved<br />
from https://adaa.org/learn-from-us/from-the-experts/<br />
blog-posts/consumer/top-ten-covid-19-anxietyreduction-strategies<br />
Centers for Disease Control and Prevention (2018). Influenza<br />
Vaccination Coverage Among Health Care Personnel-<br />
United States, 2017-2018. https://www.cdc.gov/mmwr/<br />
volumes/67/wr/mm6738a2.htm<br />
Pless, A., McLennan, S., Nicca, D., Shaw, D. and Elger,<br />
B., (2017). Reasons why nurses decline influenza<br />
vaccination: a qualitative study. BMC Nurse 2017;<br />
16:20. Retrieved from https://www.ncbi.nlm.nih.gov/<br />
pmc/articles/PMC5410084/<br />
Smith, s., Sim, J., and Halcomb, E., (2016). Nurses’<br />
knowledge, attitudes and practices regarding influenza<br />
vaccination: an integrative review. Journal of Clinical<br />
Nursing Oct;25(19-20). Retrived from https://pubmed.<br />
ncbi.nlm.nih.gov/27206347/
Page 12 • <strong>Nevada</strong> <strong>RNformation</strong> <strong>December</strong> <strong>2020</strong>, January, February 2021<br />
Addressing Sleep Problems During the COVID-19 Pandemic<br />
Denise S. Rowe DNP, APRN, FNP-BC<br />
The Covid-19 Pandemic has produced significant<br />
stressors including mass unemployment, financial<br />
hardships, and an increase in mental and physical<br />
health conditions. Health care workers are on the<br />
frontline providing the first line of care to those<br />
infected and sick due to COVID-19. Stressors from the<br />
pandemic are high. Consequently, surveys of healthcare<br />
workers report high incidences of problems sleeping.<br />
Sleep is vital to the maintenance of the body’s<br />
defense system and for promoting homeostasis. Along<br />
with diet and exercise, healthy sleep—of adequate<br />
quality, duration and timing is one of three pillars of<br />
maintainable health (Goldstein and Walker , 2014),<br />
Sleep disruptions and deficits interfere with<br />
immune system responses by interrupting circadian<br />
rhythms, negatively impact the endocrine system that<br />
manage and maintain internal bodily functions and<br />
some cytokines (IL=-1, IL-6, TNF-a) which are linked<br />
to disease and immunosuppression (Besedovsky,<br />
Lange, and Haack, 2019; Irwin, 2015; Santos, Tufik, &<br />
De Mello, 2007). While sleep deficits have not been<br />
directly linked to an increase in diagnoses of COVID-19,<br />
immunosuppression from sleep deficits can increase<br />
the risk for opportunistic diseases and worsen clinical<br />
outcomes resulting from COVID-19.<br />
When stressors are high the body often triggers an<br />
inflammatory response to eliminate the stressors and<br />
aid the body system in reverting back to a normal state<br />
of homeostasis.<br />
Since the onset of COVID-19, high insomnia rates<br />
(34-36%) have frequently been reported among<br />
frontline healthcare who care for patients at risk or<br />
diagnosed with COVID-19 (Lai, et al., <strong>2020</strong>; Zhang et<br />
al., <strong>2020</strong>). Healthcare workers face higher stress from<br />
providing care to COVID-19 patients, fear of getting<br />
infected themselves and constantly facing death<br />
by working on the frontlines. These circumstances<br />
contribute to sleep disturbances at home.<br />
Epidemiological data show that nurses experience<br />
high incidences of sleeping problems. Among nurses,<br />
57% to 83% reported having insomnia, inadequate<br />
sleep, sleep deprivation and poor quality of sleep<br />
(Qiu et al., <strong>2020</strong>; Zdanowicz, Turowski, Celej-Szuster,<br />
Lorencowicz, & Przychodzka, <strong>2020</strong>) , and up to 50%<br />
of nurse worldwide reported short sleep duration<br />
(Furihata, Saitoh, Suzuki, et al., <strong>2020</strong>; Stimpfel, Fatehi,<br />
& Kovner, 2019). A larger study in the United States<br />
found that 68.1% of nurses regularly slept less than<br />
seven hours and 11.4% slept less than five hours<br />
(Stimpfel et al., 2019). It is important to note that the<br />
National Sleep Foundation recommends that adults<br />
should sleep seven to nine hours per night (Hirshkowitz<br />
et al., 2015). Nurses experiencing sleeping problems<br />
were at risk for committing errors at work. Dorian<br />
and others (2006) found sleep deprivation increased<br />
the risk of medication errors, incorrect documentation<br />
and fostered poor communication between nurses,<br />
patients, and other staff.<br />
There are many strategies available to manage<br />
or prevent sleep disturbances during the COVID-19<br />
pandemic:<br />
• Make sleep health a priority—set aside seven to<br />
eight hours per night for sleep.<br />
• If possible, maintain a regular schedule for sleep,<br />
work and recreation which provides cues, helps<br />
to maintain a routine and trains one’s individual<br />
biological clock.<br />
• For day shift workers: self-exposure to daylight<br />
as much as possible is recommended to regulate<br />
circadian rhythms and sleep-wake cycles.<br />
• For night shift workers: avoid direct exposure<br />
to sunlight on the way home from work by<br />
wearing sunglasses.<br />
• For night shift workers, setting an alarm to<br />
maintain a regular wake-up schedule. Exposing<br />
yourself to sunlight right after awakening is<br />
recommended.<br />
• Allow one hour or more to unwind before sleep.<br />
• Go to bed when sleepy.<br />
• Maintain a sleep environment that is<br />
comfortable (e.g. dark, quiet, and at around 20<br />
degrees Celsius/68 degrees Fahrenheit).<br />
• If sleep does not occur within 15-20 minutes,<br />
consider quiet activity such as reading in another<br />
room and return to bed when sleep is imminent.<br />
• Follow the same sleep routine to maintain a<br />
regular sleep-wake schedule. Arise at the same<br />
time every day. Do not sleep in regardless of<br />
sleep duration.<br />
• Avoid intense or blue light and use of electronic<br />
items (television, cell phones, tablets) in<br />
bedroom and close to bedtime. These items<br />
inhibit the release of the sleep-inducing<br />
hormone melatonin.<br />
• Use stimulants (e.g. caffeinated beverages) with<br />
caution and avoid them five to six hours before<br />
sleep; they could have negative collateral effects<br />
on the next sleep episode.<br />
• Avoid alcohol before sleep. While alcohol is<br />
initially de-arousing it has a rebound effect of<br />
increasing night-time awakenings and reducing<br />
restorative sleep.<br />
• Avoid smoking or nicotine 30 minutes before<br />
sleep. Nicotine worsens sleep quality and<br />
increased night-time awakenings.<br />
• Avoid eating too many sugary foods before<br />
sleep. They can significantly activate your<br />
metabolism and worsens sleep.<br />
• For night shift workers, have a light snack before<br />
bedtime to avoid being awakened by hunger.<br />
• Reserve bedroom for sleep and sex only—not<br />
for working or planning the next day activities.<br />
• Following sleep deprivation, a short 15<br />
to 30 minutes be effective in decreasing<br />
the homeostatic burden of the sleep drive<br />
and improving cognitive and psychomotor<br />
functioning.<br />
• Avoid napping five to six hours before longer<br />
sleep if insomnia is a problem. While insomnia<br />
can be a normal response to stressful events, if<br />
insomnia occurs several times per week, seek<br />
professional help to prevent insomnia from<br />
becoming a chronic problem.<br />
Healthy sleep is critical to coping physically and<br />
mentally with a major life event such as the COVID-19<br />
pandemic. Ongoing education is needed to remind<br />
healthcare workers about the importance of healthy<br />
sleep practices to prevent or minimize adverse health<br />
outcomes as the COVID-19 pandemic surge continues.<br />
References:<br />
Besedovsky, L., Lange, T., & Haack, M. (2019). The sleepimmune<br />
crosstalk in health and disease. Physiological<br />
reviews, 99(3), 1325-1380.<br />
Dorrian, J., Lamond, N., van den Heuvel, C., Pincombe, J.,<br />
Rogers, A. E., & Dawson, D. (2006). A pilot study of<br />
the safety implications of Australian nurses' sleep and<br />
work hours. Chronobiology international, 23(6), 1149-<br />
1163.<br />
Furihata, R., Saitoh, K., Suzuki, M., Jike, M., Kaneita, Y.,<br />
Ohida, T., ... & Uchiyama, M. (<strong>2020</strong>). A composite<br />
measure of sleep health is associated with symptoms<br />
of depression among Japanese female hospital nurses.<br />
Comprehensive Psychiatry, 97, 152151.<br />
Goldstein, A. N., & Walker, M. P. (2014). The role of sleep<br />
in emotional brain function. Annual Review of Clinical<br />
Psychology, 10, 679–708. https://doi.org/10.1146/<br />
annurev-clinpsy-032813-153716 Epub 2014 Jan 31.<br />
Hirshkowitz, M., Whiton, K., Albert, S. M., Alessi, C., Bruni,<br />
O., DonCarlos, L., ... & Kheirandish-Gozal, L. (2015).<br />
National Sleep Foundation’s updated sleep duration<br />
recommendations. Sleep health, 1(4), 233-243.<br />
Irwin, M. R. (2015). Why sleep is important for health: a<br />
psychoneuroimmunology perspective. Annual review<br />
of psychology, 66.<br />
Lai, J., Ma, S., Wang, Y., Cai, Z., Hu, J., Wei, N., ... & Tan,<br />
H. (<strong>2020</strong>). Factors associated with mental health<br />
outcomes among health care workers exposed to<br />
coronavirus disease 2019. JAMA network open, 3(3),<br />
e203976-e203976.<br />
Qiu, D., Yu, Y., Li, R. Q., Li, Y. L., & Xiao, S. Y. (<strong>2020</strong>).<br />
Prevalence of sleep disturbances in Chinese healthcare<br />
professionals: a systematic review and meta-analysis.<br />
Sleep medicine, 67, 258-266.<br />
Santos, R. V. T., Tufik, S., & De Mello, M. T. (2007). Exercise,<br />
sleep, and cytokines: is there a relation?. Sleep<br />
medicine reviews, 11(3), 231-239.<br />
Stimpfel, A. W., Fatehi, F., & Kovner, C. (<strong>2020</strong>). Nurses'<br />
sleep, work hours, and patient care quality, and safety.<br />
Sleep health, 6(3), 314-320.<br />
Zdanowicz, T., Turowski, K., Celej-Szuster, J., Lorencowicz,<br />
R., & Przychodzka, E. (<strong>2020</strong>). Insomnia, sleepiness,<br />
and fatigue among polish nurses. Workplace Health &<br />
Safety, 68(6), 272-278.<br />
Zhang, C., Yang, L., Liu, S., Ma, S., Wang, Y., Cai, Z., ... &<br />
Zhang, J. (<strong>2020</strong>). Survey of insomnia and related social<br />
psychological factors among medical staff involved in<br />
the 2019 novel coronavirus disease outbreak. Frontiers<br />
in Psychiatry, 11, 306.<br />
Loneliness and Social Isolation...continued from page 5<br />
Feeling lonely and socially isolated can contribute to<br />
unhealthy behaviors such as getting too little exercise,<br />
drinking too much alcohol and smoking.<br />
Loneliness is also an important social stressor<br />
that can activate the body’s stress responses. When<br />
prolonged, that response can lead to increased<br />
inflammation and reduced immunity, particularly in<br />
older adults. Inflammation is the body’s response<br />
to fight off infection or heal an injury, but when it<br />
continues unchecked it can have a harmful impact<br />
on health. Stress hormones play an important role<br />
in making sure that inflammation doesn’t get out of<br />
control. But, under chronic stress, the body becomes<br />
less sensitive to the effects of the stress hormones,<br />
leading to increased inflammation and eventually<br />
disease.<br />
In healthy older people, loneliness is related to<br />
a stress hormone pattern similar to that of people<br />
who are under chronic stress. This altered pattern in<br />
the stress response explained why people who were<br />
lonelier had poorer attention, reasoning and memory<br />
ability.<br />
Social activity can buffer against the decline<br />
Maintaining high quality relationships may be a key<br />
for protecting brain health from the negative impacts<br />
of loneliness.<br />
Older adults who feel more satisfied in their<br />
relationships have a 23% lower risk of dementia, while<br />
those who feel their relationships are supportive have<br />
a 55% lower risk of dementia, compared to those who<br />
feel dissatisfied or unsupported in their relationships.<br />
Maintaining social activity also buffers against<br />
decline in thinking abilities, even for those who live<br />
alone or who have signs of beta-amyloid accumulation<br />
in their brain. One reason for these benefits to brain<br />
health is that maintaining strong social ties and<br />
cultivating satisfying relationships may help people to<br />
cope better with stress; people who feel better able to<br />
cope with difficulties or bounce back after a stressful<br />
event show less buildup of tau protein in their brains.<br />
This is good news because, with the importance<br />
of social distancing for controlling the COVID-19<br />
pandemic, how people manage their feelings and<br />
relationships is likely more important for brain health<br />
than the fact that they are spending time physically<br />
apart.<br />
Strategies for coping with loneliness<br />
Loneliness is a common and normal human<br />
experience. An important first step is to recognize this<br />
and accept that what you are feeling is part of being<br />
human.<br />
Rather than focusing on what’s not possible at the<br />
moment, try to refocus your attention on what you can<br />
do to stay connected and make a plan to take action.<br />
This could include planning to reach out to friends<br />
or family, or trying new activities at home that you<br />
normally wouldn’t have time for, such as online classes<br />
or book clubs.<br />
During times of high stress, self-care is essential.<br />
Following recommendations to maintain regular<br />
exercise and sleep routines, healthy eating and<br />
continuing to engage in enjoyable activities will help<br />
to manage stress and maintain mental and physical<br />
health.<br />
Karra Harrington is a Postdoctoral Research Fellow,<br />
Clinical Psychologist, at Pennsylvania State University.<br />
Martin J. Sliwinski is the Professor of Human<br />
Development and Family Studies, Director of the Center<br />
for Healthy Aging, at Pennsylvania State University.
<strong>December</strong> <strong>2020</strong>, January, February 2021 <strong>Nevada</strong> <strong>RNformation</strong> • Page 13<br />
Nurses in the News<br />
By Tracey Long PhD, APRN<br />
Some people are born to be a nurse. Some people are<br />
also born with special gifts and when they’re both, the<br />
world is blessed.<br />
One couple, Branden Murphy and Kristine Hafner are<br />
those kinds of people that embody the spirit of nursing.<br />
They are both pediatric nurses in Las Vegas, <strong>Nevada</strong> who<br />
met while trying to adopt the same child on a pediatric<br />
unit. In the following interview, you’ll feel their passion for<br />
children.<br />
What made you interested in being a foster parent?<br />
As a pediatric nurse who worked with hundreds of<br />
children, I noticed that special needs kids who didn't get to go to a foster home<br />
went to a skilled nursing home. That bothers me because it’s not natural for a child’s<br />
home to be a facility. I believe kids should be at home with a family that loves them<br />
and a dog by their side. I love special needs children. The more complex they are the<br />
more I love them. It's just normal for me to want to give great nursing care to them.<br />
When I turned 30, I still wasn't married, and I always wanted to be a parent.<br />
I decided to become a single foster parent. Leon was my first foster baby. I met<br />
Leon when he was nine days old in 2015, and he was admitted for shaken baby<br />
syndrome. His older brother was also badly abused with multiple burns. A third<br />
sibling was born into this dysfunctional family and Leon was the youngest. All three<br />
children have now been adopted and the parents are currently incarcerated. I was<br />
his foster parent for two years and then was able to adopt him as a single parent<br />
and he was such a blessing to me. He has a G tube, is trach dependent, and has<br />
central deafness and blindness. He has hydrocephaly as his brain couldn't develop<br />
so he is chronologically five years old, but his ability is as a three-month-old. "They<br />
took away 1/2 his brain by being a shaken baby," stated the grandmother. He is so<br />
cute; I just love him!<br />
How did you both meet?<br />
I met my wife when we were both trying to adopt the same child, we cared for<br />
in her PICU unit and through foster care. She had just adopted Steven, who was<br />
beaten up at 11 months old with over 20 fractures, a deflated lung and missing<br />
most of his teeth with a broken jaw. She has a huge heart and always wanted to<br />
take home so many babies with special needs. We met by a mutual nurse friend.<br />
We were both trying to adopt Skyler, a two-year-old who was born with her<br />
intestines outside of her body, known as gastroschisis, due to parental alcoholism<br />
and meth use.<br />
Kristine fell in love with me when I took Leon snow sledding which made her<br />
realize I want a normal life for these children. We both believe these children should<br />
be able to experience life as normal. I’ve taken our special needs children swimming,<br />
sledding and all kinds of activities to allow them a normal life, even with a trach<br />
tube or special equipment.<br />
Additional stories on this impressive couple can be found at:<br />
https://news.gcu.edu/<strong>2020</strong>/05/he-advocates-for-foster-kids-in-multiple-ways/<br />
http://epubs.democratprinting.com/publication/?i=641416&article_<br />
id=3556812&view=articleBrowser<br />
https://news3lv.com/features/heroes/local-nurse-takes-passion-of-the-practicefrom-the-hospital-to-home<br />
Branden currently serves on the <strong>Nevada</strong> State Board of Nursing since 2019. He<br />
has been working as a nursing professor for Arizona College of Nursing and after<br />
hours he volunteers his time to be an advocate for children and providing a home to<br />
children without options. Branden is in the process of opening Silver State Pediatrics,<br />
which is a new skilled nursing facility in Las Vegas. He will be the Assistant Director<br />
of Nursing.<br />
Kristine works as a PICU nurse at Sunrise Hospital in Las Vegas, <strong>Nevada</strong> and must<br />
work hard to not fall in love with every patient!<br />
Image Source: family picture taken by the Murphy family through Make a<br />
Wish Foundation. Branden and Kristine Murphy and their four children<br />
Who are your other children?<br />
In addition to my first son Leon and her first adopted son Steven, we have now<br />
adopted Skyler who is dependent on permanent intravenous feedings, and our<br />
biological daughter London. Our hobbies are really taking care of medically complex<br />
children and becoming advocates for them. We also continue to foster medically<br />
complex children and currently have one foster baby.<br />
What is your advice for foster parents?<br />
If you have the desire or ability to serve as a foster parent, it’s a great<br />
opportunity. There are so many children who need a loving and stable home. Just<br />
be careful because you might fall in love and want to keep the child if you’re lucky!<br />
These kids deserve to be loved by a family.<br />
Who pays for their care?<br />
All the children have Medicaid. We spend a lot of time trying to navigate the<br />
health system. We have great compassion for those who aren’t nurses and are<br />
trying to be an advocate for their own special need’s children because it’s not an<br />
easy process.<br />
What is your advice for helping pediatric populations?<br />
It is estimated that about 80-90 percent of car seats for children are installed<br />
incorrectly so we as nurses need to educate our parent populations about correct<br />
installation.<br />
West Hills Hospital located in Reno, NV, a leader in<br />
the treatment of behavioral, mental health care and<br />
substance abuse treatment is seeking FT/PT/PRN<br />
Registered Nurses to implement the nursing process<br />
as it relates to our programs.<br />
Visit www.westhillshospital.net and click on<br />
CAREERS to apply.
Page 14 • <strong>Nevada</strong> <strong>RNformation</strong> <strong>December</strong> <strong>2020</strong>, January, February 2021<br />
SAVE THE DATE!<br />
Nurses Day At The Legislature<br />
Tuesday, March 2, 2021<br />
<strong>Nevada</strong> State Legislature<br />
401 S. Carson Street<br />
Carson City, NV<br />
Free CEU’s will be provided!<br />
Watch for registration details on NNA’s website<br />
https://nvnurses.org/<br />
Rural & Frontier<br />
Fundraiser/Symposium<br />
JOIN US! 2-day Virtual Conference - Presented<br />
by the <strong>Nevada</strong> Nurses Foundation (Rural & Frontier<br />
Friendly Fundraiser)<br />
Visit - nvnurses.org; https://nvnursesfoundation.org/<br />
Networking and Informative Seminars<br />
January 22, 2021 5pm to 8pm<br />
January 23, 2021 8am to 12 pm<br />
Nursing Continuing Education Units Available<br />
Possible Presentations:<br />
• Adolescent Mental Health<br />
• Human Trafficking<br />
• Keeping the Patient with COVID-19 Safe<br />
• LGBTQIA+<br />
• Medicinal Marijuana<br />
• Opioid Abuse<br />
• Self-Care<br />
Register before January 1st for a discounted fee.<br />
Students who are not members of NSNA<br />
may join NSNA and have their registration<br />
fees waived.<br />
www.nsna.org<br />
Questions?<br />
Please contact Sandy Olguin<br />
at sandyolguin@live.com<br />
Scholarships to attend may be available, contact<br />
Sandy at above email or at<br />
775-335-9554<br />
REGISTER HERE<br />
FOR SYMPOSIUM<br />
https://events.r20.constantcontact.com/register/eventReg?oeidk=<br />
a07ehfedmq79c88affc&oseq=&c=&ch=
<strong>December</strong> <strong>2020</strong>, January, February 2021 <strong>Nevada</strong> <strong>RNformation</strong> • Page 15<br />
The 20/20 Vision: <strong>Nevada</strong> Nursing Student Association Empowerment<br />
Jessica Rasamimanana, NVNSA Southern<br />
Regional Director<br />
Chelsey Honrud, NVNSA Secretary<br />
Iris Isabel Martinez, NVNSA President<br />
The <strong>Nevada</strong> Nursing Student Association (NVNSA)<br />
has fiercely empowered <strong>Nevada</strong> nursing students<br />
and exudes resilience. This year has brought many<br />
opportunities, and no one could ever have imagined<br />
it would be possible to thrive amid a pandemic.<br />
However, NVNSA found 20/20 clarity and will only<br />
continue to rise in the coming years. Below are two of<br />
the most significant accomplishments NVNSA has had<br />
the honor to participate in, as recounted by Jessica<br />
Rasamimanana (NVNSA Southern Regional Director)<br />
and Chelsey Honrud (NVNSA Secretary).<br />
clinical skills. We have partnered with many of the<br />
Southern <strong>Nevada</strong> Region schools and have student<br />
nurse volunteers come out from UNLV, NSC, Roseman,<br />
and CSN the first of every month and as needed. We<br />
are so grateful to bring so many schools and people<br />
together through this volunteering experience. When<br />
we can help others through simple acts of kindness,<br />
we can fully experience an event that allows us to<br />
work cumulatively towards our goals. By supporting<br />
our nursing students, we have allowed for expanded<br />
knowledge of diabetes resources and the creation of<br />
a wide range of opportunities for advancement. It has<br />
been gratifying to be a part of something that helps to<br />
better our community, and we cannot wait to be a part<br />
of our next event.<br />
As <strong>2020</strong> ended and we move into 2021, we cannot<br />
wait for all the future opportunities we have yet to<br />
encounter. Most importantly, we are eager to take on<br />
all the many challenges to enter our path, as we have<br />
all experienced first-hand the gift of growth and strong<br />
leadership it brings. NVNSA would like to thank all the<br />
fierce and resilient nurses who continue to inspire NV<br />
nursing students and continue to show us the power of<br />
a nurse’s heart!<br />
<strong>Nevada</strong> Nurses Foundation SSON Student<br />
Event & Gala: It was such an honor for several<br />
NVNSA members to be named 'Rising Stars' as nursing<br />
students in <strong>Nevada</strong>. To be recognized for the work we<br />
are doing for our fellow students was so validating.<br />
NVNSA has been providing many opportunities for<br />
nursing students in <strong>Nevada</strong>. NVNSA hosted a virtual<br />
event for <strong>Nevada</strong> nursing students, the Shining Stars of<br />
Nursing (SSON) Gala. The SSON student event provided<br />
students from all over the state with networking and<br />
informational sessions regarding furthering their<br />
education, financial planning, job opportunities, and<br />
a mini NCLEX review, all free of charge. While NVNSA<br />
provided this free to students, this occasion served as<br />
a fundraiser for the NVNSA 2021 convention. At the<br />
SSON Gala, we had an opportunity to meet and learn<br />
from nurses in <strong>Nevada</strong> and gain more insight into the<br />
profession we are about to enter. Speaking with the<br />
"50 under 50" nurses and hearing about the fantastic<br />
things they are doing for the nursing profession in<br />
<strong>Nevada</strong> was inspirational; we cannot wait to join the<br />
nursing profession officially.<br />
SAVE THE DATE!!!<br />
Bringing together nursing students throughout<br />
<strong>Nevada</strong>. We are one big team! #Strongertogether<br />
Shining Stars of <strong>Nevada</strong>: Behind the scenes<br />
of the annual Shining Stars of <strong>Nevada</strong> (SSON)<br />
Student virtual event, the NVNSA coordinated<br />
and ran the student event.<br />
• NCLEX Hurst Review<br />
• Pharmacology Kahoot review<br />
• Resume review + Interview tips<br />
• Exhibitors<br />
• Raffle prizes<br />
• Student scholarship giveaway<br />
• Alumni panel<br />
• NCLEX review giveaways<br />
• and much more!<br />
NVNSA 3rd Annual Convention<br />
via zoom on Saturday, May 29th @ 8am<br />
THEME: New Grad RN Bootcamp:<br />
No limits to success!<br />
Support the next generation of nurses. From new graduate<br />
RN’s, to incoming nursing students, to high school students!<br />
We would love to see you here! #Strongertogether<br />
More details coming soon!<br />
*Contact president.nvnsa@gmail.com for any questions*<br />
Live in Las Vegas!<br />
We offer outstanding career opportunities for qualified<br />
people who share our commitment to providing expert<br />
healthcare and excellent customer service.<br />
The <strong>Nevada</strong> Nurses Foundation awarded NVNSA<br />
Board of Directors and NVNSA members the<br />
<strong>2020</strong> Rising Star Certificate. A huge honor and<br />
indeed an amazing night!<br />
D.I.V.A. Program: Another significant opportunity<br />
that we have been able to bring to our fellow<br />
nursing students was collaborating with the Diabetes<br />
Intervention for a Victorious and Active Lifestyle<br />
program, otherwise known as the D.I.V.A program.<br />
This event was an amazing opportunity for our fellow<br />
students to be out in the community, educate, practice<br />
our skills, and encompass all NVNSA stands for.<br />
These volunteers can assist with taking manual blood<br />
pressures, blood sugar monitoring, weights, and other<br />
Our employees enjoy opportunities for professional<br />
development and career advancement, as well as<br />
a competitive compensation and benefits package.<br />
We offer:<br />
* Growth Opportunities * Vacation, Sick, Holiday Pay<br />
* Generous 401k * Medical/Dental/Vision<br />
* Education Reimbursement<br />
EOE<br />
We are currently recruiting<br />
full-time and per diem<br />
Registered Nurses and<br />
other Clinical Support<br />
Come Join the Family! Apply online.<br />
Recruiter: (702) 657-5580<br />
www.northvistahospital.com
Page 16 • <strong>Nevada</strong> <strong>RNformation</strong> <strong>December</strong> <strong>2020</strong>, January, February 2021<br />
UMC Annual Research Empowerment Day <strong>2020</strong> – Virtual Edition<br />
Heather Spaulding, MSN, RN, RN-BC, CPN<br />
Cheri Filewood, RN<br />
The Chief Nursing Officer of University Medical<br />
Center of Southern <strong>Nevada</strong> (UMC), Debra Fox, had a<br />
vision for a day where interprofessional healthcare<br />
workers came together to support UMC’s vision of<br />
being a premier academic medical center. Her vision<br />
became a reality on May 9, 2018, when UMC hosted<br />
their First Annual Research Empowerment Day. This<br />
day's three objectives are to bring evidence-based<br />
practice to the bedside, recognize research excellence<br />
formally, and enhance UMC's partnership in higher<br />
learning (Neue & Walker, 2018).<br />
The First Annual Research Empowerment Day set<br />
the foundation for the future of research at UMC.<br />
The first event was held at UMC and featured 54<br />
posters in the categories of care presentations, clinical<br />
research, completed clinical projects, proposed clinical<br />
projects, and knowledge enhancement. Poster authors<br />
represented medicine, nursing, therapies, pharmacy,<br />
academia, and even engineering. A neutral panel<br />
of judges reviewed the posters using preset criteria.<br />
Winners were announced during a live event with<br />
certificates and ribbons presented. This first event's<br />
overwhelming response established a platform for<br />
highlighting clinical research (Walker, 2018). Contact<br />
hours for continuing education were awarded for<br />
attending the event and completing the event’s<br />
evaluation.<br />
Building upon the first year's success, the Second<br />
Annual Research empowerment Day showed growth<br />
with an additional twenty posters. On September<br />
11, 2019, 74 posters were featured from different<br />
interprofessional team members from UMC (UMC<br />
Hospital, 2019) and healthcare professionals in<br />
academia. Posters were judged using the same five<br />
categories for the second year, and winners were<br />
announced during a live event with certificates and<br />
ribbons presentations.<br />
With the success of the first two years, UMC's<br />
Research Empowerment Day Committee had set a goal<br />
to feature 100 posters for <strong>2020</strong>. There was a plan to<br />
add two additional categories for healthcare profession<br />
students–undergraduate and healthcare professions<br />
students–graduate to allow future healthcare workers<br />
such as medical students, nursing students, therapy<br />
students, and more to highlight their work in a<br />
professional venue. As the planning committee began<br />
to plan the Third Annual Research Empowerment<br />
Day, the world suddenly found itself in the middle<br />
of a pandemic. All healthcare-related conferences<br />
and UMC's Research Empowerment Day came to<br />
a screeching halt while our frontline staff worked<br />
diligently to assist patients affected by this new disease.<br />
The healthcare community began to learn more<br />
about this new virus, and the Centers for Disease<br />
Control and Prevention (CDC) put guidelines in place<br />
to keep everyone safe. The CDC asked everyone to<br />
practice social distancing (CDC, <strong>2020</strong>) and limit large<br />
gatherings. With the new social distancing guidelines<br />
in place, those who plan conferences and events<br />
to advance healthcare knowledge began to seek<br />
alternatives to these types of events.<br />
Working with the UMC's Infection Preventionists,<br />
incident command, and senior leadership, the planning<br />
committee was approved to move forward with a<br />
virtual venue. A call for posters went out. Despite<br />
the short notice, the planning committee was able to<br />
obtain participants to partake in the third annual event,<br />
demonstrating that the healthcare community desired<br />
to grow from research even during difficult times.<br />
With the new virtual venue, the committee sought<br />
to ensure that guests outside of UMC could participate<br />
in the event. The planning committee worked diligently<br />
with the marketing team and the web developer to<br />
create this new virtual venue. Twenty-six posters were<br />
accepted from various UMC disciplines and two from<br />
our academic partners to total twenty-eight posters.<br />
These posters were the displayed on UMC’s webpage<br />
within their respective categories.<br />
With the social distancing guidelines, another<br />
challenge the planning committee faced was the<br />
annual award celebration. The planning committee<br />
concluded that the best way to celebrate was to host<br />
a virtual celebration via WebEx, with posters on virtual<br />
display on November 18 and 19, <strong>2020</strong>. This event<br />
concluded on November 19, <strong>2020</strong>, from 1030 to<br />
1200, with authors present to answer the attendees'<br />
questions. The event started with welcomes from<br />
UMC's CEO and CNO and a brief presentation of<br />
posters by poster authors, followed by the poster<br />
winners' announcement.<br />
Despite a global pandemic, UMC has seen active<br />
participation in the Annual Research Empowerment<br />
Day initiative. Due to our healthcare workers' busy<br />
schedules, the posters are approved to remain as an<br />
active Continuing Education event for a full year. The<br />
ongoing poster displays will allow additional UMC staff<br />
and all healthcare providers in <strong>Nevada</strong> and beyond, to<br />
visit the site and obtain FREE 1.5 Contact Hours using<br />
the link below.<br />
www.umcsn.com/virtualposterday<br />
UMC thanks all healthcare workers near and far for<br />
their service. We hope you will take the time to visit<br />
our site, review the posters, and complete the survey to<br />
obtain your free contact hours.<br />
References<br />
CDC. (<strong>2020</strong>, Nov 17). Social distancing: Keep a safe<br />
distance to slow the spread. Retrieved from Centers<br />
for Disease Control and Prevention: https://www.cdc.<br />
gov/coronavirus/2019-ncov/prevent-getting-sick/socialdistancing.html<br />
Neue, P. C., & Walker, V. (2018, March). UMC hosts first<br />
annual research empowerment day. <strong>Nevada</strong> State<br />
Board of Nursing News, p. 23. Retrieved from http://<br />
epubs.democratprinting.com/publication/?m=11381&i=<br />
486576&p=22&article_id=3052224&ver=html5<br />
UMC Hospital. (2019, September). UMC Hospital @UMCSN<br />
Tweet. Retrieved from https://twitter.com/UMCSN/<br />
status/1172620856058494978<br />
Walker, V. (2018, September). 2018 UMC Research<br />
Empowerment Day. <strong>Nevada</strong> State Board of<br />
Nursing News, p. 8. Retrieved from http://epubs.<br />
democratprinting.com/publication/?m=11381&i=52925<br />
3&p=8&ver=html5<br />
Registered Nurses<br />
Adventure awaits in the Carson Valley - close to skiing,<br />
boating, fishing or any other sport you like! You can<br />
even ride your bike to work! Save money, less time<br />
commuting and spend more time with your family!<br />
Working conditions, taxes and health are better<br />
here in Douglas County than in any other county in<br />
Northern <strong>Nevada</strong>. It’s greener on this side of <strong>Nevada</strong> -<br />
rugged, relaxed, reachable! Come join the family. At<br />
Carson Valley Medical Center Hospital we are seeking<br />
to expand our Nursing staff. Located in Gardnerville<br />
<strong>Nevada</strong>, 20 miles from beautiful South Lake Tahoe,<br />
CVMC is a full-service critical access hospital.<br />
CVMC supports an ICU unit, med tele unit, outpatient<br />
infusion center, ambulatory surgery center and 24<br />
hour ER. 6 months recent critical care experience<br />
required. Successful applicant will be scheduled<br />
a combination of shifts in the ICU and Med-Surg/<br />
Telemetry department.<br />
CVMC offers competitive wages and benefits, plus a<br />
retention bonus of $5,000 over 2 years employment.<br />
Interested applicants please apply online at<br />
cvmchospital.org or call 775-782-1514.
<strong>December</strong> <strong>2020</strong>, January, February 2021 <strong>Nevada</strong> <strong>RNformation</strong> • Page 17<br />
Leadership in Policy and Care Quality and Safety<br />
Nursing Policy in Times of Uncertainty surviving, thriving on the edge<br />
As we confront new and existing realities and move<br />
into this decade launched by the Year of the Nurse<br />
and Midwife, we critically examine the history and the<br />
future of nursing by inaugurating a new column called,<br />
Leadership in Policy, Care Quality and Safety. The<br />
purpose of the column is to engage nurses in dialogue<br />
and galvanize them to take leadership in the individual<br />
but overlapping aspects of policy, care quality and<br />
safety. Each quarter you will find a short column on<br />
a topic related to one or more of these intersecting<br />
factors. Leadership is the framework that underpins<br />
each column. We believe that no matter where nurses<br />
work or the position held, leadership is a critical skill<br />
for all nurses not only those who hold titles that imply<br />
leadership, e.g. manager, director, dean, but every<br />
nurse regardless of practice setting or role. Our goal is<br />
to raise awareness about the leadership opportunities<br />
in policy, care quality, and safety across settings,<br />
specialties, communities and the globe by focusing on<br />
inspiring exemplars and action steps that that be taken<br />
by nurses.<br />
Rebecca M. Patton, DNP, RN, CNOR, FAAN<br />
Margarete L. Zalon, PhD, RN, ACNS-BC, FAAN<br />
Ruth Ludwick, PhD, RN-BC, APRN-CNS, FAAN<br />
Marian K. Shaughnessy Nurse Leadership<br />
Academy, Case Western Reserve University<br />
https://case.edu/nursing/nurse-leadershipacademy<br />
Call to Action<br />
As we write this column during the COVID-19<br />
pandemic, we are in the midst of unprecedented<br />
change and risk for our personal lives, our families,<br />
our professional lives, our communities, our country,<br />
and our world. Little did we think when we planned<br />
this column about policy, leadership, quality and<br />
safety that we would be facing one of the greatest<br />
challenges in our lifetimes. This crisis has thrust nurses<br />
into the forefront of the public’s mind. How ironic that<br />
this coincides with the World Health Organization’s<br />
declaration that this is the Year of the Nurse and the<br />
Midwife. While nurses are essential on the frontlines<br />
at the sharp edge of care, it is the lens of nurses that<br />
provide critical insights in evaluating and formulating<br />
policy to achieve quality and safety patient care<br />
outcomes.<br />
Everyday nurses walk the tightrope of uncertainty.<br />
The uncertainty of practice is a constant that<br />
requires the attention of all nurses, vigilance, and<br />
most importantly activism. COVID-19 has magnified<br />
these unknowns to astronomical proportions. The<br />
accelerated pace of uncertainty with COVID-19 has led<br />
to care dilemmas and crises, with variations in practice<br />
standards that negatively impact health outcomes.<br />
We are bombarded with challenges like mass<br />
shootings, climate change, water supply, and emerging<br />
diseases. Now we are in the midst of a pandemic,<br />
which not only impacts the health of our communities<br />
and workforce, but has dire financial consequences<br />
for so many. How many of these challenges have<br />
you faced? What challenges have you faced that are<br />
not even listed here? What will come next? We don’t<br />
always know what will come next. We do know that<br />
nurses will be there on the frontlines. When nurses<br />
are asked to volunteer in a crisis, they show up for<br />
wars, disasters, and pandemics. Nurses are in the<br />
frontlines of policy implementation. Often in times of<br />
crisis, policies are disregarded, ignored, or unofficially<br />
discarded. Nurses often know whether a policy is<br />
workable, flawed or whether it is doomed to fail. We<br />
have seen policy failures like changing instructions<br />
on the use of personal protective equipment (PPE) as<br />
supplies dwindle. On the other hand, times of crisis<br />
can lead to policy gains as illustrated by a willingness<br />
to allow advance practice registered nurses full practice<br />
authority.<br />
To counteract policy failures, correct flaws and take<br />
advantage of opportunities for policy advancements,<br />
we need to be knowledgeable, and prepared. This<br />
means participating in policy so that we understand<br />
concerns expressed by broad constituencies and take<br />
action using our nursing expertise. This expertise is<br />
needed so that the policies are realistic, workable and<br />
meet the needs they were designed to address. Policy<br />
is more than enacting a law; it includes formulating<br />
rules, regulations and guidelines. Policies occur at many<br />
levels, often simply referred to as Big “P” and little “p”,<br />
the former often focus on state, federal or international<br />
laws and the latter to local government or local<br />
associations or organizations.<br />
Move to Action<br />
Moving to action requires identifying the preferred<br />
outcome with clarity. This is achieved by examining the<br />
data, sharing information, and capitalize on your skills<br />
to move an issue forward.<br />
Know the data, appraise credibility of sources, and<br />
interpret its meaning<br />
“In God we trust, but everyone else needs to bring<br />
data”<br />
This quote attributed to Edward Fisher when<br />
testifying before Congress (Source) is a fitting start<br />
for policy involvement. Nurses have the knowledge<br />
and are in a unique position to use and leverage data<br />
for patient advocacy. Knowing the data, appraising<br />
sources and interpreting its meaning are critical steps<br />
in the processes for research, quality improvement and<br />
evidence-based practice. Nurses all have intellectual<br />
capital related to these processes regardless of their<br />
practice setting or role. Your intellectual capital can be<br />
enhanced with the following strategies:<br />
• Use the resources available from professional<br />
associations: the American Nurses Association,<br />
state nurses associations, specialty nurses<br />
associations and interdisciplinary professional<br />
groups.<br />
• Subscribe to a wide variety of data sources<br />
including journals, news alerts, list servs<br />
• Track and identify progress on issues you are<br />
passionate about<br />
• Determine the credibility of sources<br />
• Verify the facts<br />
• Identify content experts for policy issues<br />
• Interpret the meaning<br />
• Identify policy implications of research and<br />
quality improvement projects<br />
• Identify the strengths and weaknesses in the<br />
data in support of your<br />
• Sift fact verifying the facts and determining the<br />
credibility of sources<br />
• Interpret the meaning of information<br />
Have the stories, share them widely.<br />
Stories can be more powerful than only presenting<br />
data. Stories provide an emotional tug, create drama,<br />
and provide context. Stories get attention, but data<br />
strengthens the power of stories. Most stories have<br />
multiple audiences. Framing your story in a way that<br />
varying audiences understand transmits important<br />
knowledge and fosters identification with stark<br />
realities. Storying telling is subject to several caveats.<br />
With the advent of social media, sharing stories has<br />
become easier, it also has created a medium for<br />
false stories to grow exponentially (as they are often<br />
salaciously framed). Second, be aware of people<br />
and organizations that try to block stories, especially<br />
when bad news happens. (p 320 book) As the most<br />
trusted profession, nurses have a strategic position<br />
opportunity to frame and share their narratives widely<br />
with a variety of audiences at the little p to the Big P<br />
to level as outlined below varying audiences and frame<br />
stories using the following avenues. These strategies<br />
are not static and can be adapted to the virtual world.<br />
Garnering the support of colleagues, stakeholders and<br />
the public can be accomplished with these strategies:<br />
• Post digital content (social media)<br />
• Disseminate facts and reports in print media<br />
(fact sheets, policy briefs, articles, letters, press<br />
releases)<br />
• Disseminate research findings<br />
• Engage key stakeholders<br />
• Contact legislators about key issues on an<br />
ongoing basis and when votes come up<br />
• Speaking up at public meetings<br />
• Presenting in public forums<br />
• Model inspirational behaviors<br />
• Participate in town hall meetings<br />
• Meet with legislators and regulators<br />
• Create elevator speeches<br />
• Be social media savvy<br />
Know your skills, capitalize on them.<br />
Nurses have the skills to move beyond only being<br />
implementers of policy and only on the sharp edge of<br />
policies; we need to be the developers of policies. To<br />
capitalize on the potential of four million nurses, all<br />
nurses in any setting or role need to assess how their<br />
skills can be applied to policy. This positions nurses to<br />
enhance practice and the work environment as well as<br />
advance issues of importance to nurses and the public<br />
we serve. Policy work needs to become ingrained as<br />
part of the culture of nursing. P. 470<br />
Common and overlooked strategies to improve an<br />
individual policy role would include the following which<br />
you can act upon immediately :<br />
• Register and vote<br />
• Be a poll worker<br />
• Join interest-based organizations and become an<br />
active member<br />
• Finding a mentor<br />
• Volunteer to work on a campaign.<br />
• Serve on a workplace committee, task force or<br />
practice council<br />
• Attend networking events<br />
• Participate in legislative days<br />
• Contribute to candidates and political action<br />
committees<br />
• Complete your profile for Nurses on Boards<br />
(nursesonboard.org)<br />
• Seek local community board positions<br />
• Communicate with elected officials<br />
• Capitalize on workplace communication<br />
channels for policy discussions<br />
• Volunteering for an organizational or<br />
community-based initiative<br />
The following are generally are longer term actions,<br />
but can be done in the short-term as well depending<br />
your policy trajectory:<br />
• Assume a leadership role for a workplace<br />
committee, task force or practice council<br />
• Be a mentor<br />
• Representing your organization to the external<br />
community<br />
• Seek an internship or fellowship with a legislator<br />
or other policymaker<br />
• Further your formal policy and content education<br />
• Serve on a political action committee board<br />
• Seek a board position<br />
• Volunteer for appointed office<br />
• Run for office in your organization or community<br />
In times of uncertainty, there are certainties. One<br />
certainty is the mandate for all nurses becoming<br />
involved in policy. The American Nurses Association’s<br />
Code of Ethics for Nurses’ (2015) supports nurses’ roles<br />
in policy with the expectation that nurses advocate<br />
for the health and safety of patients, collaborate in<br />
the promotion of health, work to improve the ethical<br />
environment of practice settings, and advance the<br />
profession through nursing and health policy.<br />
We have highlighted strategies that nurses should<br />
use to increase their involvement in making policy<br />
decisions to strengthen our practice and improve the<br />
health of the public we serve. The collective action of<br />
over four million nurses in our country and 21 million<br />
nurses across the globe has the potential to be a<br />
powerful force for policy change.<br />
American Nurses Association. (2015). Code of Ethics<br />
for Nurses with interpretive statements. Silver Spring,<br />
MD: Author. https://www.nursingworld.org/practicepolicy/nursing-excellence/ethics/code-of-ethics-fornurses/
Page 18 • <strong>Nevada</strong> <strong>RNformation</strong> <strong>December</strong> <strong>2020</strong>, January, February 2021<br />
<strong>Nevada</strong> Nurses Foundation EST 2014<br />
Rural & Frontier Nursing Scholarship Fundraiser<br />
Join us on Friday, January 22nd and<br />
Saturday, 23rd, 2021<br />
2-day Virtual Conference Networking &<br />
Informative Seminar<br />
Brian Dankowski<br />
Karen Bearer<br />
Denise Ogletree<br />
McGuinn<br />
Presentations:<br />
• Adolescent Mental Health<br />
• Keeping the Patient with COVID-19 Safe<br />
• Caring for the Patient who identifies with LGBTQ<br />
• American Cannabis Nurses Association<br />
• Opioid Abuse<br />
• Holistic Nurses Association<br />
The Rural & Frontier Nursing Scholarship is awarded<br />
to a rural certified nursing assistant, licensed practical<br />
nurse, or a registered nurse pursuing an advanced<br />
nursing degree. For more information, please contact<br />
us at solguin@nvnursesfoundation.org or 775-560-<br />
1118.<br />
Rural & Frontier Nurse Recipients<br />
Important 2021 <strong>Nevada</strong> Nurses Foundation Dates:<br />
2021 Rural & Frontier Nursing Symposium<br />
January 22 and 23, 2021<br />
2021 7th Annual Big Hat High Tea<br />
March 27, 2021 (COVID-willing) at the NV Governor’s<br />
Mansion<br />
2021 Grant Application<br />
October 1, <strong>2020</strong> to February 1, 2021<br />
2021 Scholarship Application<br />
February 1-28, 2021<br />
August 1-28, 2021<br />
2022 Grant Application<br />
October 2, 2021 to February 1, 2022<br />
2021 6th Annual Shining Stars of Nursing Student<br />
Nurse Event<br />
October 2, 2021 (student nurse conference)<br />
2021 6th Annual Shining Stars of Nursing in <strong>Nevada</strong><br />
Awards Gala<br />
October 2, 2021 in Las Vegas, <strong>Nevada</strong><br />
2021 Tuesday Giving<br />
November 30, 2021<br />
In 2014, the <strong>Nevada</strong> Nurses Foundation (NNF)<br />
gained federal recognition as a 501(c)(3), non-profit<br />
organization. The mission is to increase access to<br />
quality healthcare for <strong>Nevada</strong> citizens by promoting<br />
the professional development of nursing through<br />
scholarships, grants, and recognition.<br />
The NNF started with an idea which lead to many<br />
discussions, a lot of paperwork, collaboration, and a<br />
healthy amount of time, money, and commitment.<br />
Thank you to the initial NNF Board of Directors, Mrs.<br />
Margaret Curley, Barbara Wardwell, and Calmoseptine<br />
for believing in the NNF!<br />
Photographed: The first <strong>Nevada</strong> Nurses Foundation<br />
Board of Directors from left to right, Elizabeth Fildes<br />
(Director), Denise Ogletree McGuinn (Vice President),<br />
Sandy Olguin President), Betty Razor (Treasurer), and<br />
Susan Growe (Secretary).<br />
<strong>Nevada</strong> Nurses Foundation Values<br />
• Integrity: the quality of being honest and having<br />
strong moral principles.<br />
• Collaboration: the action of working with others<br />
to produce or create something.<br />
• Quality: a distinctive degree of excellence; high<br />
standard or condition.<br />
• Stewardship: the action of being fiscally<br />
responsible.<br />
The first scholarships were awarded in 2015 to the<br />
following nurses:<br />
• Doreen Begley; $1,000.00, NNF RN to BSN<br />
Scholarship<br />
• Annie Carlos; $1,000.00, Vroman & Wildes<br />
Scholarship<br />
• Linda Cirillo; $1,000.00, NNF Pre-lic Scholarship<br />
• Amy Edelman; $1,000.00, Arthur L. Davis<br />
Publishing Scholarship<br />
• Robin Hollen; $1,000.00, Vroman & Wildes<br />
Scholarship<br />
• Heidi Johnston; $2,500.00, NNF Doctorate<br />
Scholarship<br />
• Maria Poggio D’Errico; $2,500.00. NNF Master’s<br />
in Nursing Scholarship<br />
• Delene Volkert; $1,048.00 <strong>Nevada</strong> Nurses<br />
Association Legacy Scholarship<br />
• Michael York; $500.00, NNF Pre-lic Scholarship<br />
• Richard Young; $500.00, NNF Pre-lic Scholarship<br />
<strong>2020</strong> <strong>Nevada</strong> Nurses Foundation Board of<br />
Directors<br />
President/CEO: Dr. Sandy Olguin<br />
Vice President: Rev. Dr. Denise Ogletree McGuinn<br />
Chief Financial Officer: Nicki Aaker<br />
Treasurer: Dr. Glenn Hagerstrom<br />
Secretary: Karen Bearer<br />
Director & Community Outreach: Dave Tyrell<br />
Director & Community Outreach: Dr. Heidi Johnston<br />
Photographed: Dave Tyrell, Sandy Olguin, Karen<br />
Bearer, Denise Ogletree McGuinn, and Glenn<br />
Hagerstrom. Missing Nicki Aaker and Heidi Johnston<br />
Please join me in welcoming new NNF Advisory<br />
Board members; Dr. Caren Jaggers, Dr. Sherri Lindsey,<br />
and Lauren Parker!<br />
Allyson Waldron, RN<br />
2016<br />
Annette Clark, RN<br />
2017<br />
Christina Scilacci,<br />
CNA 2019<br />
Stephanie<br />
McGilvrey, RN 2017<br />
Register for Elko Symposium Here!<br />
<strong>2020</strong> Scholarship Recipients<br />
Spring<br />
• Nicole Cabrera-Heiring, BSN, RN, CLC;<br />
$1,000.00, NNF Scholarship Recipient<br />
• Anna Maria Holder, CCMA, BS, $1,000.00, NNF<br />
Scholarship Recipient<br />
• Yolanda Gardner, RN, ASN; $1,000.00, NNF<br />
Scholarship Recipient<br />
• Wendy Merchant, MSN-Ed, CNS, RN; $1,000.00,<br />
NNF Doctorate Scholarship<br />
• Casey Pruyt, CNA, AA; $1,000.00, NNF CNA-RN<br />
Scholarship Recipient<br />
• Masha Zelenin, RN; $1,000.00, <strong>2020</strong> Jessie J.<br />
Valentine Scholarship<br />
Fall<br />
https://events.r20.constantcontact.com/register/eventRe<br />
g?oeidk=a07ehfedmq79c88affc&oseq=&c=&ch=
<strong>December</strong> <strong>2020</strong>, January, February 2021 <strong>Nevada</strong> <strong>RNformation</strong> • Page 19<br />
<strong>Nevada</strong> Nurses Foundation EST 2014
Page 20 • <strong>Nevada</strong> <strong>RNformation</strong> <strong>December</strong> <strong>2020</strong>, January, February 2021<br />
<strong>Nevada</strong> Nurses Foundation EST 2014<br />
Congratulations <strong>Nevada</strong> Nurses Foundation scholarship recipients! Thank you<br />
for pursing your education! We are so PROUD of YOU! Thank you to all of our<br />
scholarship donors and Legacy Scholarship sponsors.<br />
Thank you to the <strong>Nevada</strong> Nurses<br />
Foundation Endowment sponsors for<br />
establishing an endowed scholarship fund<br />
and placing your trust in the <strong>Nevada</strong> Nurses<br />
Foundation!<br />
The following endowments have raised<br />
nearly ~$70,000.00.<br />
• Karen Bearer; Frontline Heroes<br />
Endowment Fund<br />
• Erick Christopherson Endowed Legacy<br />
Scholarship<br />
• Margaret and Ian Curley Endowed<br />
Nursing Scholarship<br />
• Greg Peistrup Endowed Legacy<br />
Scholarship<br />
• Debra & John Scott Endowed Nursing<br />
Scholarship<br />
• Yvette Wintermute Legacy Scholarship<br />
Endowment<br />
Debra Scott and Dr. John Scott<br />
Margaret and Ian<br />
Curley<br />
Erick Christopherson<br />
Greg Peistrup<br />
Yvette<br />
Wintermute<br />
Karen Bearer, sponsoring<br />
Frontline Heroes<br />
Endowment Fund<br />
To access electronic copies of the<br />
<strong>Nevada</strong> <strong>RNformation</strong>, please visit<br />
http://www.nursingALD.com/publications<br />
Threads of eNVy, a local Las Vegas business, has been very generous to the<br />
<strong>Nevada</strong> Nurses Foundation. They created these amazing T-shirts as a way to give<br />
back and support nurses in <strong>Nevada</strong>. The NNF receives proceeds from the sale of the<br />
Support Local Heroes shirt.<br />
Purchase your T-shirt at Threads of eNVy.<br />
Follow, Like and share their Instagram page.<br />
The Big Hat High Tea normally held at the Governor’s Mansion, was interrupted<br />
by the COVID-19 pandemic where we moved our event from March to August <strong>2020</strong><br />
and from in-person to virtual. Recognizing and honoring our scholarship and grant<br />
recipients wasn’t the same this year, however, we celebrated everyone, listened to<br />
amazing entertainers and had a wonderful time!
<strong>December</strong> <strong>2020</strong>, January, February 2021 <strong>Nevada</strong> <strong>RNformation</strong> • Page 21<br />
<strong>Nevada</strong> Nurses Foundation EST 2014<br />
Thank you, Rev. Dr. Denise Ogletree McGuinn for<br />
being the Mistress of Ceremonies from the comfort<br />
of your home in Las Vegas. Thank you Karen Bearer<br />
and Dr. Mary Bondmass for traveling from Las Vegas<br />
to Reno to help with the virtual tea. Thank you for<br />
presenting. Your valuable contributions prior to<br />
and during the event went above and beyond my<br />
expectations. Thank you, Nicki Aaker for presenting<br />
and creating the souvenir program. You’re a hard<br />
worker and a reliable team member. Thank you<br />
Alyx Olguin, for volunteering and coordinating food<br />
and beverages for everyone! Thank you, Dr Glenn.<br />
Hagerstrom, for taking care of all the financial matters,<br />
including raffle ticket sales and silent auction payments<br />
all the way from Florida. Thank you, Lyle Pritchett, for<br />
creating a wonderful online silent auction!<br />
• 2019: Mary Poppins<br />
• <strong>2020</strong>: Crowns & Tiaras<br />
<strong>2020</strong> Shining Stars of Nursing Student Event<br />
Saturday, October 3, <strong>2020</strong>.<br />
Chelsey Honrud (NVNSA secretary), Jessica<br />
Rasamimanana (NVNSA So. Regional Director),<br />
Iris Martinez (NVNSA President), Katie<br />
Rutherford (No. Regional Director), and Karen<br />
Nava (NVNSA Breakthrough to Nursing Director)<br />
Karen Nava & Katie<br />
Thank you to our wonderful Silent Auction Donors<br />
and Winners!! Painting created and donated by Blair<br />
Latos, RN!<br />
Thank you to the <strong>Nevada</strong> Nurses Association<br />
District 1 for sponsoring $500 toward the raffle prizes.<br />
Congratulations to our raffle prize winners.<br />
$500 Visa Gift Card: Jolinda Cabras Ramos<br />
$300 Southwest Airline Voucher: Dr. Heidi Johnston<br />
$200 Amazon Gift Card: Mitzi Husbands<br />
Thank you to our NNF Big Hat High Tea Planning<br />
Team and silent auction sponsors.<br />
Iris Martinez & Katie Rutherford leading the <strong>2020</strong><br />
Shining Stars Student Nurse Event.<br />
Jessica Rasamimanana<br />
Erika Manasewitsch, Shelby Pauletto,<br />
Robert Branda, & Sean Lacsamana<br />
Thank you, Darlene Salvo, NNF<br />
Advisory Board member and NNF<br />
Entertainment Director for directing<br />
an amazing entertainment line-up.<br />
Many thanks to Marsh Broeder, The<br />
Fabulous Trio (Robert Branda, Erika<br />
Manasewitsch, Shelby Pauletto),<br />
Robert Miller, Darlene and Martin<br />
Salvo,<br />
Marsh Broeder Thank you, Kelly Farley, for your<br />
wonderful silent auction pictures<br />
and behind the scenes wizardry needed to run the<br />
Zoom event. Your resilience, optimism and cleverness<br />
are valuable attributes!<br />
Every year, we change the theme of the Big Hat<br />
High Tea. Let’s see if you can match the year with the<br />
theme.<br />
• 2015: Over the Rainbow<br />
• 2016: My Fair Lady<br />
• 2017: Mad Hatter<br />
• 2018: The Wild West Tea<br />
Mary Bondmass and Lauren Park<br />
Karen Bearer<br />
CCSD, SOUTHWEST CAREER<br />
& TECH HIGH SCHOOL<br />
seeking full-time CNA Instructor<br />
Must be a licensed nurse.<br />
Contact Donna Levy, Principal<br />
Levydm@nv.ccsd.net
Page 22 • <strong>Nevada</strong> <strong>RNformation</strong> <strong>December</strong> <strong>2020</strong>, January, February 2021<br />
<strong>Nevada</strong> Nurses Foundation EST 2014<br />
<strong>2020</strong> People’s Choice Director of Nursing<br />
Congratulations, Tracey McCollum, Carson Tahoe<br />
Health’s Shining Stars of Nursing in <strong>Nevada</strong> <strong>2020</strong><br />
People’s Choice DON! You’re amazing!<br />
Tracey McCollum, MSN, RN, CENP, NEA-BC has just<br />
been appointed to be a Board Member on the <strong>Nevada</strong><br />
State Board of Nursing! Congratulations, Tracey!<br />
Tracey was joined by her Carson Tahoe Health<br />
Family! Cassidy Jost, Danielle Dare, Joanne Miller, Kim<br />
Kammann, Megan Martinez, Janelle Martin, Maria<br />
Freed, Jim Freed, and Dee Tison!<br />
Beth and Darren Melton<br />
Seeking Adventurous,<br />
Compassionate Nurses<br />
Doris Bauer, <strong>2020</strong> Distinguished Nurse Leader<br />
with Lifetime Achievement<br />
Primary<br />
Stroke<br />
Center<br />
Knee Hip<br />
Replacement Replacement<br />
Spine<br />
Surgery<br />
Pain<br />
Management<br />
Chest<br />
Pain<br />
Center<br />
Leapfrog<br />
Award<br />
Patient<br />
Safety<br />
Award<br />
Looking for Exceptional Nurses...<br />
Northern <strong>Nevada</strong> Medical Center offers progressive employee<br />
programs including a culture of Service Excellence that honors<br />
outstanding employee efforts at every level. We provide a generous<br />
benefits/compensation package, 401K and tuition reimbursement.<br />
You’ll enjoy the innovative approaches to personalized health care<br />
in our 124-bed acute care hospital located on a scenic hillside over<br />
looking the Truckee Meadows in Sparks, NV.<br />
For more information, please call Leah Webb at<br />
775-356-4085 or visit www.nnmc.com/careers.<br />
2375 E. Prater Way,<br />
Sparks, NV 89434
<strong>December</strong> <strong>2020</strong>, January, February 2021 <strong>Nevada</strong> <strong>RNformation</strong> • Page 23<br />
<strong>Nevada</strong> Nurses Foundation EST 2014<br />
SAVE THE DATE: Shining Stars of Nursing in <strong>Nevada</strong><br />
in LAS VEGAS, NV on Saturday, October 2nd, 2021!<br />
There are many foundations and organizations<br />
competing for your funds and on behalf of the <strong>Nevada</strong><br />
Nurses Foundation, we appreciate your past and future<br />
support and charitable donations.<br />
Thank you and have great days,<br />
Sandy<br />
Previous Big Hat High Tea themes include My Fair<br />
Lady (2015), Mary Poppins (2016), Mad Hatter (2017),<br />
Over the Rainbow (2018), and Crowns and Tiaras<br />
(2019), and The Wild West Tea on the Comstock.<br />
Facebook: @<strong>Nevada</strong>NursesFoundation<br />
Instagram: <strong>Nevada</strong>nursesfoundation_<br />
LinkedIn: https://www.linkedin.com/company/<br />
nevada-nurses-foundation/<br />
Twitter: @NNF_nurses<br />
Legal Representation for<br />
Medical Professionals<br />
If the board calls, we have the answer!<br />
Our attorneys have been protecting the livelihood of<br />
doctors and nurses in <strong>Nevada</strong> for over 40 years.<br />
Clark Hill is a multidisciplinary, national law firm that<br />
draws on our attorneys’ industry and policy knowledge,<br />
our deeply held shared values, and a global network of<br />
premier firms and advisors to provide innovative legal<br />
solutions and client-service excellence worldwide.<br />
www.clarkhill.com<br />
Contact John A. Hunt, Esq.<br />
702.697.7512<br />
jhunt@clarkhill.com<br />
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